Organization
FORDAM UNIVERSITY
Active
Organization
FORDAM UNIVERSITY
Active
Other names
Fordham Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR)
(972) 367-4845
Entity
Organization
Contact information
Practice address
441 E FORDHAM RD, BRONX, NY 10458-5149
(972) 367-4845
Mailing address
15305 DALLAS PKWY STE 800, ADDISON, TX 75001-6415
(972) 367-4845
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
03/21/2018
Last updated
12/17/2021
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