Active NPI
Texas Southern University
- Sports Medicine (Orthopaedic Surgery) Physician
- Houston, TX
National Provider Identifier
1720435308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- N3308
- Legal business name
- TEXAS SOUTHERN UNIVERSITY
- Doing business as
- Texas Southern University Sports Medicine
- Practice address
- 3100 Cleburne St
Houston, TX 77004-4501 - Phone
- (713) 313-7011
- NPI assigned
- May 24, 2016
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | N3308 | TX | Primary |
Addresses
Primary practice location
3100 Cleburne St
Houston, TX 77004-4501
Mailing address
5050 Spring Valley Rd
Dallas, TX 75244-3909
Phone (972) 367-4845
Other names 1
- Texas Southern University Sports Medicine
National Provider Directory
National Provider Directory- Tax ID family
- Student Health Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Student Health Clinic/Center
- Houston, TX
- NPI 1669785853
Locations
3100 Cleburne St
Houston, TX 77004
Phone (713) 313-4325
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Student in an Organized Health Care Education/Training Program
- Houston, TX
- NPI 1336993997
-
- Student in an Organized Health Care Education/Training Program
- Houston, TX
- NPI 1548996952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1464048000000",
"number": "1720435308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 SPRING VALLEY RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752443909",
"telephone_number": "972-367-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 CLEBURNE ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770044501",
"telephone_number": "713-313-7011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEXAS SOUTHERN UNIVERSITY",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-24",
"last_updated": "2016-05-24",
"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": "207XX0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "TX",
"license": "N3308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Texas Southern University Sports Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.