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Organization
WEBER STATE UNIVERSITY
Active
Organization
WEBER STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1001 UNIVERSITY CIR, OGDEN, UT 84408-5525
(972) 367-4845
(972) 367-3451
Mailing address
15305 DALLAS PKWY STE 800, ADDISON, TX 75001-6415
(972) 367-4845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
02/06/2015
Last updated
12/17/2021
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