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

McLennan Community College

Organization Sports Medicine (Family Medicine) Physician · NPI 1124701412

McLennan Community College is a Sports Medicine (Family Medicine) Physician in Waco, Texas. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1400 College Dr
Waco, TX 76708-1402
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 number1124701412
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names McLennan Athletics
NPI enumeratedAugust 11, 2023
Last updated in NPPESAugust 11, 2023
Certification dateAugust 11, 2023
Mailing address15305 Dallas Pkwy Ste 800, Addison, TX 75001-6415

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