Organization
NEW MEXICO JUNIOR COLLEGE
Active
Other names
New Mexico Junior College Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3909
(972) 367-4845
Mailing address
5317 N LOVINGTON HWY, HOBBS, NM 88240-9121
(575) 392-4510
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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