Organization
BRAZOS VALLEY PHYSICIANS ALLIANCE
Active
Other names
Central Texas Sports Medicine & Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5900
Entity
Organization
Contact information
Practice address
3121 UNIVERSITY DR E STE 100, BRYAN, TX 77802-3499
(979) 776-0169
(979) 776-1372
Mailing address
3121 UNIVERSITY DR E STE 100, BRYAN, TX 77802-3499
(979) 776-0169
(979) 776-1372
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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