Organization
GEORGE WASHINGTON UNIVERSITY
Active
Other names
George Washington 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
600 22ND ST NW, CHARLES E. SMITH CENTER, WASHINGTON, DC 20052-0055
(202) 994-6650
Mailing address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD6727
DC
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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