OrganizationActive
University of Tulsa
NPI 1639844129 · Sports Medicine (Family Medicine) Physician · Tulsa, OK
Provider details
- NPI number
- 1639844129
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mouzon Bass, Administrator/Agent(972) 367-4845
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
800 S Tucker Dr
Tulsa, OK 74104-9700
Phone: (972) 367-4845
Approximate (ZIP-level) locationGet directions
Mailing address
15305 Dallas Pkwy Ste 800
Addison, TX 75001-6415
Other names (DBA / former)
- Doing business as
- University of Tulsa Athletics
- Doing business as
- University of Tulsa Athletics
Registry dates
- Enumerated
- 2021-08-16
- Last updated
- 2021-12-17
- Certified
- 2021-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.