Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

University of Tulsa

Organization Sports Medicine (Family Medicine) Physician · NPI 1639844129

University of Tulsa provides Sports Medicine (Family Medicine) Physician services in Tulsa, Oklahoma. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

800 S Tucker Dr
Tulsa, OK 74104-9700
Phone: (972) 367-4845
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1639844129
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names University Of Tulsa Athletics; University Of Tulsa Athletics
NPI enumeratedAugust 16, 2021
Last updated in NPPESDecember 17, 2021
Certification dateDecember 17, 2021
Mailing address15305 Dallas Pkwy Ste 800, Addison, TX 75001-6415

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