Grayson College

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

GRAYSON COLLEGE

Doing business as

Grayson College Athletics

Practice address

6101 Grayson Dr
Denison, TX 75020-8307

Phone

(972) 367-4845

Fax

(972) 367-3451

NPI assigned

Jun 24, 2022

Last updated

Jun 24, 2022By the provider in NPPES

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

Administrator/Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• GRAYSON COLLEGE ATHLETICS Doing business as

Locations

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1962133496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 DALLAS PKWY STE 800",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016415",
            "telephone_number": "972-367-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 GRAYSON DR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750208307",
            "telephone_number": "972-367-4845",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYSON COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR/AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAYSON COLLEGE ATHLETICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathryn Gomez, MS, CCC-SLP
• Portia Gonzales
• Cheyenne Goucher, PA-C
• Sarah E Grady, NP
• Gabrielle Gralino, MS, RDN, LD
• Grayson Emergency Physicians
• Greater Texoma Health Clinic
• Preston Blake Green, PTA
• Taylor Greenhalgh
• Erin Griffin, AGACNP-BC

• Sports Medicine (Family Medicine) Physician in Denison, TX
• Providers in Denison, TX by specialty
• Sports Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.