| Sul Ross Sports Medicine | |
|
79830 Us 90 Alpine TX 79830 | |
| (972) 367-4845 | |
| Not Available |
| Full Name | Sul Ross Sports Medicine |
|---|---|
| Speciality | General Practice |
| Location | 79830 Us 90, Alpine, Texas |
| Authorized Official Name and Position | Mouzon Bass (ADMINISTRATOR/AGENT) |
| Authorized Official Contact | 9723674845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sul Ross Sports Medicine 5050 Spring Valley Rd Dallas TX 75244-3995 | Sul Ross Sports Medicine 79830 Us 90 Alpine TX 79830 Ph: (972) 367-4845 |
| NPI Number | 1649742255 |
|---|---|
| Provider Enumeration Date | 12/20/2018 |
| Last Update Date | 12/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649742255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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