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SPORTS BACK & PAIN MANGEMENT CLINIC NPI 1275786469


NPI Information

NPI: 1275786469
Provider Name: SPORTS, BACK & PAIN MANGEMENT CLINIC
Classification: Physical Therapist - 2251X0800X
Entity Type: Organization

Specialization: Orthopedic

Address:
2011 #A VILLA MARIA RD
BRYAN, TX
ZIP 77802
Phone: (979) 776-2225
Get Directions

SPORTS, BACK & PAIN MANGEMENT CLINIC is an orthopedic physical therapist in Bryan, TX. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. SPORTS, BACK & PAIN MANGEMENT CLINIC NPI is 1275786469. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2011 #A VILLA MARIA RD
BRYAN, TX
ZIP 77802-541
Phone: (979) 776-2225
Fax: (979) 776-7945

The provider's authorized official is Leon F Bradway .
The authorized official title is Physical Therapist and has the following contact phone number (979) 776-2225.

The enumeration date for this NPI number is 10/31/2008 and was last updated on 10/31/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225100000XPhysical Therapist1055085TEXASNo
22251E1300XPhysical TherapistElectrophysiology, Clinical1055085TEXASNo
32251G0304XPhysical TherapistGeriatrics1055085TEXASNo
42251H1300XPhysical TherapistHuman Factors1055085TEXASNo
52251S0007XPhysical TherapistSports1055085TEXASNo
62251X0800XPhysical TherapistOrthopedic1055085TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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