Organization
ABILENE CHRISTIAN UNIVERSITY
Active
Other names
ACU Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1600 CAMPUS CT, ABILENE, TX 79601-3761
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G5644
TX
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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