SPORTS, BACK & PAIN MANGEMENT CLINIC


Address: 2011 #a Villa Maria Rd, Bryan, TX 77802-2541
Phone: 9797762225

SPORTS, BACK & PAIN MANGEMENT CLINIC (NPI# 1275786469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275786469
Entity Type Organization
Organization Name SPORTS, BACK & PAIN MANGEMENT CLINIC
Practice Address 2011 #a Villa Maria Rd
Bryan
TX 77802-2541
Practice Telephone 9797762225
Practice Fax Number 9797767945
Mailing Telephone 9797762225
Mailing Fax Number 9797767945
Enumeration Date 2008-10-31
Last Update Date 2008-10-31
Authorized Official Name LEON F BRADWAY (PHYSICAL THERAPIST)
Authorized Official Telephone 9797762225
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 225100000X Physical Therapist 1055085 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 2251E1300X Physical Therapist
Specialization: Electrophysiology, Clinical
1055085 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 2251G0304X Physical Therapist
Specialization: Geriatrics
1055085 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 2251H1300X Physical Therapist
Specialization: Human Factors
1055085 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 2251S0007X Physical Therapist
Specialization: Sports
1055085 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 2251X0800X Physical Therapist
Specialization: Orthopedic
1055085 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 2011 #A VILLA MARIA RD
City BRYAN
State TX
Zip Code 77802-2541

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013476951 Andrea Pittman Student in an Organized Health Care Education/Training Program Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 2019-03-19
1942789110 Alicia Diane Ates Dentist 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 2018-08-09
1588151682 Metx LLC Audiologist-Hearing Aid Fitter 3030 E 29th St Ste 102, Bryan, TX 77802 2018-04-16
1073047437 Abbi Messer Family Medicine 2900 29th Street, Suite 100, Bryan, TX 77802 2017-04-12
1265885180 Scott Andrew Thayer Dentist 3811 Stoneparc Dr, Bryan, TX 77802 2016-07-15
1255792123 Phoebe Mathew Pharmacist 3312 East 29th Street, Bryan, TX 77802 2016-03-18
1801253810 Pearl Coleshill Specialist/Technologist 3121 University Drive E., Suite 100, Bryan, TX 77802 2016-01-21
1265847750 Wesley Danielle Daniels Dietitian, Registered 3900-c Carter Creek Pkway, Bryan, TX 77802 2014-06-24
1235549098 Regina V. Robertson Home Health 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 2014-05-02
1982024238 Lampstand Nursing and Rehabilitation, Lp Skilled Nursing Facility 2001 E 29th Street, Bryan, TX 77802 2014-04-24
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Taxonomy Information

Taxonomy Code 2251X0800X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapist
Specialization Orthopedic

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518430883 Alexander Thompson Howe Physical Therapist 3700 Cross Park Dr, Bryan, TX 77802-4137 2019-01-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1245837889 Jeremy Tan Physical Therapist 505 S Friendswood Dr Ste 101, Friendswood, TX 77546-2254 2020-10-06
1184232100 Cindy Hon Pt Pllc Physical Therapist 3832 Gildas Path, Pflugerville, TX 78660-4168 2020-07-15
1114544095 Morgan Sanders Physical Therapist 2419 Tx 121, Bedford, TX 76021 2020-06-26
1790300226 Jave Del Rosario Physical Therapist 3601 N Macgregor Way Ste 514, Houston, TX 77004-8004 2020-06-10
1922634724 Carra Dudley Physical Therapist 415 E Parkwood Ave, Friendswood, TX 77546-5149 2020-03-13
1013542513 Alexis Nicole Shoope Physical Therapist 3300 Cummins St Apt 2329, Houston, TX 77027-5992 2020-03-05
1861026437 Robin Elizabeth Mcgee Physical Therapist 2555 Gulf Fwy S Ste 400, League City, TX 77573-6742 2020-02-23
1811520612 Christopher William Chenault X Physical Therapist 14857 Southwest Fwy # C303, Sugar Land, TX 77478-5016 2020-02-20
1770116584 Jordan William Ordoyne Physical Therapist 545 Creekside Xing Ste 138, New Braunfels, TX 78130-4271 2020-02-20
1972136851 Nicole Marie Baker Physical Therapist 9180 Pinecroft Dr, Shenandoah, TX 77380-2794 2020-02-19
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Competitor

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City BRYAN
Zip Code 77802

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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