Paul V Bonarrigo

Primary specialty

SpecialistTaxonomy code 174400000X

License

1005635 Issued in TX

Legal business name

PAUL V BONARRIGO

Doing business as

Sports and Back Clinic

Practice address

2011A E Villa Maria Rd
Bryan, TX 77802-2541

Phone

(979) 776-2225

Fax

(979) 776-7945

NPI assigned

Nov 7, 2006

Last updated

Apr 14, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul V Bonarrigo, LPTNPI 1881760205

Title

Owner

Phone

(979) 776-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sports and Back Clinic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul V Bonarrigo, LPT, PC

  • Specialist
  • Bryan, TX
  • NPI 1881760205
  NPD (past) Authorized official
• Leon F. Bradway III, PHYSICIAL THERAPIST

  • Physical Therapist
  • College Station, TX
  • NPI 1932179306
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1437228830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011-A E VILLA MARIA",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77802",
            "telephone_number": "979-776-2225",
            "fax_number": "979-776-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011A E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022541",
            "telephone_number": "979-776-2225",
            "fax_number": "979-776-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL V BONARRIGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "BONARRIGO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-776-2225",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "1005635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0092QS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports and Back Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Edward Patke
• Patricia Nation, PHD
• Patrick S. Burchfield DDS, PC (Southern SMiles, Family and Cosmetic Dentristry)
• Shameel Pattani, PHARMD
• Paul Roquet MD PA
• Emily Renee Payne
• Eric D Payton Jr., LPC
• Jatisha Payton
• Collin James Peacock, PHARMD
• Roderick Leighton Peddy, DC

• Specialist in Bryan, TX
• Providers in Bryan, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.