Provider Demographics
NPI:1215234414
Name:STEEN, MASON RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:MASON
Middle Name:RYAN
Last Name:STEEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 E. UNIVERSITY,
Mailing Address - Street 2:SUITE B
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3110 E. UNIVERSITY,
Practice Address - Street 2:SUITE B
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762
Practice Address - Country:US
Practice Address - Phone:432-550-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor