Individual provider Active NPI

Carlo Clement Brual

  • Physical Therapist
  • Conroe, TX
National Provider Identifier
1831986975
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1189931 Issued in TX
Practice address
9931 Beautyberry
Conroe, TX 77385-5607
Phone
(508) 808-3771
Fax
(508) 863-9737
NPI assigned
Apr 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18106 MA
Physical Therapist 225100000X 1189931 TX Primary

Addresses

Primary practice location

9931 Beautyberry
Conroe, TX 77385-5607

Mailing address

9931 Beautyberry
Conroe, TX 77385-5607
Phone (508) 863-9737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001985 TX Practitioner - Physical Therapist in Private Practice 6709304074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Luna Care Physical Therapy LLCGroup PAC ID 0648692723, 271 clinicians

Practice addresses (Care Compare)

180 State St
Suite 225
Southlake, TX 76092-7632
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18106MAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 14, 2025 Accepting new patients
Baylor College of Medicine CurrentSince May 14, 2025 Accepting new patients
Baylor College of Medicine CurrentSince May 14, 2025 Accepting new patients

Locations

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1831986975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9931 BEAUTYBERRY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773855607",
            "telephone_number": "508-863-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9931 BEAUTYBERRY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773855607",
            "telephone_number": "508-808-3771",
            "fax_number": "508-863-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUAL",
        "first_name": "CARLO",
        "middle_name": "CLEMENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18106",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1189931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.