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

Sports, Back & Pain Mangement Clinic

Organization Physical Therapist · NPI 1275786469

Sports, Back & Pain Mangement Clinic is a Physical Therapist in Bryan, Texas. Licensed in Texas. Registered with an NPI since 2008.

Licensed in
TX
In the registry since
2008
Specialties on file
6
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Practice location Address checks out

2011 #A Villa Maria RD
Bryan, TX 77802-2541
Phone: (979) 776-2225
Fax: (979) 776-7945
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X · Licence 1055085 (TX)
Physical Therapist Taxonomy 225100000X · Licence 1055085 (TX)
Clinical Electrophysiology Physical Therapist Taxonomy 2251E1300X · Licence 1055085 (TX)
Geriatric Physical Therapist Taxonomy 2251G0304X · Licence 1055085 (TX)
Human Factors Physical Therapist Taxonomy 2251H1300X · Licence 1055085 (TX)
Sports Physical Therapist Taxonomy 2251S0007X · Licence 1055085 (TX)

Record details

NPI number1275786469
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leon Bradway — Physical Therapist · (979) 776-2225
NPI enumeratedOctober 31, 2008
Last updated in NPPESOctober 31, 2008
Mailing address2011 #A Villa Maria Rd, Bryan, TX 77802-2541

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