Provider Demographics
NPI:1750123253
Name:PACE, MASON JORDAN (OT)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:JORDAN
Last Name:PACE
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11900 RESEARCH RD APT 3420
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3699
Mailing Address - Country:US
Mailing Address - Phone:817-300-9992
Mailing Address - Fax:
Practice Address - Street 1:11900 RESEARCH RD APT 3420
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3699
Practice Address - Country:US
Practice Address - Phone:817-300-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics