Provider Demographics
NPI:1831242585
Name:MASON, AMY R (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:6811 AUSTIN CENTER BLVD, #300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3166
Practice Address - Country:US
Practice Address - Phone:512-344-0312
Practice Address - Fax:512-344-0315
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2021-05-20
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Provider Licenses
StateLicense IDTaxonomies
TXL7474207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187059401Medicaid
TX187059402Medicaid
TX187059401Medicaid
TX187059402Medicaid
TX8J8528Medicare PIN