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Organization
REGIONAL UNIVERSITY SYSTEM OF OKLAHOMA
Active
Organization
REGIONAL UNIVERSITY SYSTEM OF OKLAHOMA
Active
Other names
SEOSU Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MUZON BASS III (ADMINISTRATOR)
(972) 367-4845
Entity
Organization
Contact information
Practice address
425 W UNIVERSITY BLVD, DURANT, OK 74701-3347
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(972) 367-4845
(972) 367-3451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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