Organization
GRAND VIEW UNIVERSITY
Active
Other names
Grand View Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1200 GRANDVIEW AVE, JOHNSON WELLNESS CENTER, DES MOINE, IA 50316-1529
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
23873
IA
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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