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Organization
SALESIAN HIGH SCHOOL
Active
Organization
SALESIAN HIGH SCHOOL
Active
Other names
SALESIAN HIGH SCHOOL ATHLETICS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOUZON BASS III (ADMINISTRATOR/AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
2851 SALESIAN AVE, RICHMOND, CA 94804-1025
(972) 367-4845
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
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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