OrganizationActive
State of Louisiana
NPI 1578950028 · Sports Medicine (Family Medicine) Physician · Hammond, LA
Provider details
- NPI number
- 1578950028
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mouzon Bass, Agent(972) 367-4845
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Orthopaedic Surgery Physician207X00000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
548 Western Ave
Hammond, LA 70402-0001
Phone: (972) 367-4845
Fax: (972) 367-3451
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 650850
Dallas, TX 75265-0850
Other names (DBA / former)
- Doing business as
- Southeastern Louisiana Sports Medicine
Registry dates
- Enumerated
- 2015-04-22
- Last updated
- 2015-04-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.