Letourneau University

NPI #1932598513 in Longview, Texas

Provider Information

NPI Number: 1932598513
Entity Type: Organization
Organization Name: Letourneau University
Primary Specialty: Family Medicine
Enumeration Date: Jan 20, 2015
Last Updated: Jan 20, 2015

Practice Location

Address: 2100 S MOBBERLY AVE
City: Longview
State: Texas
ZIP Code: 75602-3564
Phone: (903) 233-3760

Authorized Official

Name: MOUZON BASS III
Title: AGENT
Phone: 18005559073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Sports Medicine — Sports Medicine	207QS0010X
Family Medicine	207Q00000X	Primary

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