| Drive Nation Sports | |
|
1200 Sycamore St Waxahachie TX 75165-2397 | |
| (972) 367-4845 | |
| Not Available |
| Full Name | Drive Nation Sports |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 1200 Sycamore St, Waxahachie, 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 |
|---|---|
| Drive Nation Sports 15305 Dallas Pkwy Ste 800 Addison TX 75001-6415 Ph: (972) 367-4845 | Drive Nation Sports 1200 Sycamore St Waxahachie TX 75165-2397 Ph: (972) 367-4845 |
| NPI Number | 1386319812 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 12/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386319812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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