| NPI | 1407336605 |
|---|---|
| Doing Business As | SPU SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |