Active NPI
Carlo Clement Brual
- Physical Therapist
- Conroe, TX
National Provider Identifier
1831986975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1189931
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18106 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Luna Care Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
| Baylor College of Medicine | Current | Accepting new patients | |
| Baylor College of Medicine | Current | 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.
-
- Physical Therapist
- Southlake, TX
- NPI 1790309656
-
- Ph.D. Medical Genetics
- Houston, TX
- NPI 1881026664
-
- Orthopaedic Surgery Physician
- Sugar Land, TX
- NPI 1700683844
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.