| NPI | 1659018901 |
|---|---|
| Doing Business As | SALESIAN HIGH SCHOOL ATHLETICS |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator/Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2022-05-18 |