Design: 1-1/2" x 1-11/16"
It is a commemorative medal for for the 1904 No-Tsu-Oh festival in Houston. No-Tsu-Oh (Houston spelled backward) was started in 1899 as festival to attract tourists and business people to Houston to see our fair city and the big navigation channel to the coast. It devolved into a Mardi Gras-like affair with non-stop partying and was ended after WW1 as it was judged too rowdy. Today there's an appropriately nonconformist bar that bears the name...
Here is a video from 2019 explaning it: https://abc13.com/no-tsu-oh-festival-houston-history/1398725/?fbclid=IwAR28gXMjcZUGlbqYgDkh4W7g9xcl0g31kwL1agqnTx7zDs_ZdLW_SivzVZ0