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

Brigham Young University

Organization Family Medicine Physician · NPI 1790175628

Brigham Young University is a Family Medicine Physician in Provo, Utah. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

173 Richards Bldg Dance Dept
Provo, UT 84602-2000
Phone: (972) 367-4845
Fax: (972) 367-3452
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1790175628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (972) 367-4845
Other names Byu Dance
NPI enumeratedJanuary 30, 2015
Last updated in NPPESMay 11, 2017
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995

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