Fort Hays State University

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0537903 Issued in KS

Legal business name

FORT HAYS STATE UNIVERSITY

Practice address

5050 Spring Valley Rd.
Dallas, TX 75244-3909

Phone

(972) 367-4845

NPI assigned

Jun 3, 2016

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 1

Addresses

Other names 1

• Fort Hays State Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1609224310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PARK ST",
            "address_2": "#1",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676014009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443909",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT HAYS STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "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": "KS",
            "license": "0537903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Hays State Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Earl Nelson Forsyth, MD
• Jennifer Anne Forsyth, M.D.
• Brian C Forsythe, D.O.
• Dylan Lee Forsythe, DO
• Mary Christine Forsythe, RD, LD
• Fort Worth Neurotech, PA
• Fort Worth Smiles by Wire, PLLC
• Stephanie Joy Fort, SLP
• Tyra M Fort
• Angela Henslee Forte, FNP

• Family Medicine Physician in Dallas, TX
• Providers in Dallas, 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 3, 2016; 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.