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Organization

BREVARD COLLEGE

Active
Other names
BREVARD COLLEGE STUDENT HEALTH CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MOUZON BASS III (ADMINISTRATOR/AGENT)
(972) 367-4845
Entity
Organization

Contact information

Practice address
1 BREVARD COLLEGE DR, BREVARD, NC 28712-4283
(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

Other

Enumeration date
04/05/2022
Last updated
04/05/2022
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