Provider Demographics
NPI:1245887355
Name:MASON, JONATHAN THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:THOMAS
Last Name:MASON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4802 STAR JASMINE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-6059
Mailing Address - Country:US
Mailing Address - Phone:147-277-5222
Mailing Address - Fax:
Practice Address - Street 1:1900 ALDRICH ST STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3597
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU2262207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty