Healthcare Provider Details

I. General information

NPI: 1861575466
Provider Name (Legal Business Name): CENTRAL TEXAS SPORTS MEDICINE & ORTHOPAEDICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 UNIVERSITY DR E STE 100
BRYAN TX
77802-3499
US

IV. Provider business mailing address

3121 UNIVERSITY DR E STE 100
BRYAN TX
77802-3499
US

V. Phone/Fax

Practice location:
  • Phone: 979-776-0169
  • Fax: 979-776-1372
Mailing address:
  • Phone: 979-776-0169
  • Fax: 979-776-1372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOE P BRAMHALL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 979-776-0169