Provider Demographics
NPI:1619686243
Name:NAY, MASON AARON
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:AARON
Last Name:NAY
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 1:711 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-2200
Mailing Address - Country:US
Mailing Address - Phone:972-935-5757
Mailing Address - Fax:
Practice Address - Street 1:11675 FM 2154 RD
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-4737
Practice Address - Country:US
Practice Address - Phone:979-485-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304432183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician