Healthcare Provider Details

I. General information

NPI: 1114851276
Provider Name (Legal Business Name): SPORTS MEDICINE AND REGENERATIVE ORTHOPEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 UNIVERSITY DR E STE 245
BRYAN TX
77802-3483
US

IV. Provider business mailing address

3201 UNIVERSITY DR E STE 245
BRYAN TX
77802-3483
US

V. Phone/Fax

Practice location:
  • Phone: 979-721-9821
  • Fax: 979-599-9160
Mailing address:
  • Phone: 979-721-9821
  • Fax: 979-599-9160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICARDO GARCIA JR.
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 979-721-9821