Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | J1304 | TX |
NPI | 1134123664 |
---|---|
Provider Name | Dr. Marcos Vincent Masson |
First Address | Houston, TX 77004-6900 |
Second Address | Houston, TX 77004-6900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 23/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130537707 | (05) | TX |
F48329 | (02) | TX |