Southwestern Assemblies of God University

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHWESTERN ASSEMBLIES OF GOD UNIVERSITY

Practice address

1200 Sycamore St
Waxahachie, TX 75165-2397

Phone

(972) 825-4671

Fax

(972) 367-3451

NPI assigned

Jun 1, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mouzon Bass III

Title

Agent

Phone

(972) 367-4845

Specialties & licenses 2

Addresses

Other names 1

• SAGU Sports Medicine Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Rhodes, LAT

  • Athletic Trainer
  • Waxahachie, TX
  • NPI 1730595760
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1245610666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650850",
            "address_2": "DEPT 1011",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650850",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SYCAMORE ST",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751652397",
            "telephone_number": "972-825-4671",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN ASSEMBLIES OF GOD UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAGU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olayinka Cecilia Sotayo, FNP
• Natalia J Southerland, MD
• Southern Plains Pavilion Associates, LLC
• Southwest Family Services, Inc.
• Southwest Regional Orthopedic Sports Medicine
• David Conley Spates, COTA
• Christopher K. Speigner, RPSGT, CCSH
• Brittney Spiegel, MSN, AGACNP-BC
• Rebecca Diane Spradlin, RD, LD
• Springbloom Therapy and Consulting Services

• Family Medicine Physician in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.