Provider Demographics
NPI:1104950294
Name:DRS. WHITE-MASON-MCELVEEN L.L.P
Entity type:Organization
Organization Name:DRS. WHITE-MASON-MCELVEEN L.L.P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-477-9775
Mailing Address - Street 1:7408 CAMERON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752
Mailing Address - Country:US
Mailing Address - Phone:512-477-9775
Mailing Address - Fax:512-477-4806
Practice Address - Street 1:7408 CAMERON RD
Practice Address - Street 2:SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752
Practice Address - Country:US
Practice Address - Phone:512-477-9775
Practice Address - Fax:512-477-4806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1111783-01Medicaid
TXBCBS CM0049OtherBCBS
TX1111809-01Medicaid
TXDD974TXMedicaid
TX724595OtherUNITED CONCORDIA
TX=========-00004OtherDELTAL DENTAL