Mason Round Rock Op LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

133434 Issued in TX

Legal business name

MASON ROUND ROCK OP LLC

Doing business as

San Gabriel Rehabilitation and Care Center

Practice address

4100 College Park Drive
Round Rock, TX 78665-1522

Phone

(512) 334-8000

Fax

(512) 334-8005

NPI assigned

Oct 4, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael A. Little

Title

Administrator

Phone

(512) 334-8000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• San Gabriel Rehabilitation and Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1366726762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 COLLEGE PARK DRIVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651522",
            "telephone_number": "512-334-8000",
            "fax_number": "512-334-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 COLLEGE PARK DRIVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651522",
            "telephone_number": "512-334-8000",
            "fax_number": "512-334-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON ROUND ROCK OP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-334-8000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "133434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "105009",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Gabriel Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zerika Martinez
• Ana Maria Masbad, PH.D.
• Brenden Masden
• Christopher A. Masi, M.D.
• Lisa R Masica, CRNA
• Brian Curtis Massey, M.D.
• Heather Nicole Mast, CNS
• Dalia Mata
• Jessica Matchett, BCBA
• Alfredo Geoffrey Mateo, D.M.D.

• Skilled Nursing Facility in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.