Provider Demographics
NPI:1275205528
Name:MASON, HALEY RAY (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:RAY
Last Name:MASON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11500 STATE HIGHWAY 121 STE 320
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9346
Mailing Address - Country:US
Mailing Address - Phone:214-618-0048
Mailing Address - Fax:
Practice Address - Street 1:2301 ELDORADO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7527
Practice Address - Country:US
Practice Address - Phone:972-330-4644
Practice Address - Fax:972-600-1272
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056014363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology