Organization
CONCORDIA UNIVERSITY TEXAS
Active
Other names
CUTX Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR/AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
11400 CONCORDIA UNIVERSITY DR, AUSTIN, TX 78726-1887
(512) 313-4524
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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