Organization · NPI-2

Brazos Valley Physicians Alliance

Orthopaedic Surgery · Bryan, TX

NPI number1609493543

StatusActive

Last updated in NPPESJun 26, 2020

Details

NPI: 1609493543
Entity type: Organization (NPI-2)
Legal business name: Brazos Valley Physicians Alliance
Organization subpart: No
Enumeration date: Jun 26, 2020
Certification date: Jun 26, 2020
Last updated: Jun 26, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207X00000X	Orthopaedic Surgery	–	–	Yes
207PS0010X	Emergency Medicine, Sports Medicine	–	–
207Q00000X	Family Medicine	–	–
2251S0007X	Physical Therapist, Sports	–	–

Other names

Central Texas Sports Medicine & Orthopaedics (Doing Business As)

Practice location

3121 University Dr E Ste 100
Bryan, TX 77802-3499

Phone 979-776-0169 · Fax 979-776-1372

Mailing address

3121 University Dr E Ste 100
Bryan, TX 77802-3499

Phone 979-776-0169 · Fax 979-776-1372

Authorized official

Jennifer Boyd Baldock
Officer And Authorized Official
6152345900

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