Organization
TEXAS SOUTHERN UNIVERSITY
Active
Organization
TEXAS SOUTHERN UNIVERSITY
Active
Other names
Texas Southern University Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
3100 CLEBURNE ST, HOUSTON, TX 77004-4501
(713) 313-7011
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3909
(972) 367-4845
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
N3308
TX
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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