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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