Individual
MR. BRIAN JAMES MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
6652 YOUREE DR, SHREVEPORT, LA 71105-4630
(318) 795-0506
(318) 795-0510
Mailing address
6652 YOUREE DRIVE, SHREVEPORT, LA 71105
(318) 795-0506
(318) 795-0510
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15629
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15629
PHARMACIST CREDENTIAL
LA
Enumeration date
08/29/2013
Last updated
08/29/2013
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