Provider Demographics
NPI:1487230231
Name:BENING, MASON
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:BENING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 SOUTH 31ST STREET
Mailing Address - Street 2:MS-01-W256
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508
Mailing Address - Country:US
Mailing Address - Phone:254-724-4507
Mailing Address - Fax:
Practice Address - Street 1:2401 SOUTH 31ST STREET
Practice Address - Street 2:MS-01-W256
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508
Practice Address - Country:US
Practice Address - Phone:254-724-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program