Organization
HOLY FAMILY UNIVERSITY
Active
Organization
HOLY FAMILY UNIVERSITY
Active
Other names
Holy Family Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
9801 FRANKFORD AVE, PHILADELPHIA, PA 19114-2009
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD028513E
PA
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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