Provider Demographics
NPI:1740617182
Name:ENGLISH, MASON JOSEPH
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:JOSEPH
Last Name:ENGLISH
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 1:6767 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-6414
Mailing Address - Country:US
Mailing Address - Phone:409-985-9365
Mailing Address - Fax:409-985-6315
Practice Address - Street 1:6767 9TH AVE
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-6414
Practice Address - Country:US
Practice Address - Phone:409-985-9365
Practice Address - Fax:409-985-6315
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2098859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist