Organization
BRAZOS ORTHOPEDIC PHYSICAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL TIMOTHY WARD P.T. (PRESIDENT/PHYSICAL THERAPIST)
(979) 776-0247
Entity
Organization
Contact information
Practice address
2701 E 29TH ST, BRYAN, TX 77802-2504
(979) 776-0247
(979) 774-9515
Mailing address
2701 E 29TH ST, BRYAN, TX 77802-2504
(979) 776-0247
(979) 774-9515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1130268
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86496T
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
05/28/2006
Last updated
08/22/2020
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