Middle Georgia State University Sports Medicine – Family Medicine Physician, NPI 1629449400

Middle Georgia State University Sports Medicine is a healthcare provider. based in Dallas, Texas. specializing in Family Medicine Physician. The NPI Number for Middle Georgia State University Sports Medicine is 1629449400

Main info

Organization
Name
Middle Georgia State University Sports Medicine
NPI
1629449400
Phone
(800) 555-9073
Address
5050 SPRING VALLEY RD
Authorized Official
MOUZON BASS III AGENT
Enumeration Date
19 October 2015
Last Update Date
19 October 2015
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness80
Years active:10State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Middle Georgia State University Sports Medicine

  • 5050 SPRING VALLEY RD

    DALLAS, TX 752443995

    Phone: (800) 555-9073

    Fax: (972) 367-3452

    Type: Mailing

  • 1100 2ND ST SE

    COCHRAN, GA 310141564

    Phone: (972) 367-4845

    Fax: (972) 367-3451

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75244)

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Reviews

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Frequently asked questions

Can I use this page to confirm Middle Georgia State University Sports Medicine's NPI?
Yes. Middle Georgia State University Sports Medicine is listed with NPI 1629449400 in the public NPI dataset.
Does the file indicate Middle Georgia State University Sports Medicine is practicing under active NPI?
Directory data currently reports Middle Georgia State University Sports Medicine as active.
What is Middle Georgia State University Sports Medicine's primary classification?
Family Medicine Physician is the headline specialty for Middle Georgia State University Sports Medicine here. Clinical services aligned with this taxonomy classification.
What area does Middle Georgia State University Sports Medicine serve?
Middle Georgia State University Sports Medicine's listing highlights Dallas, Texas; more addresses can appear in NPPES.
Why does Middle Georgia State University Sports Medicine have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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