Active NPI
Leon F. Bradway III, PHYSICIAL THERAPIST
- Physical Therapist
- College Station, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1055085
- Practice address
- 800 Scott and White Dr
College Station, TX 77845-6440 - Phone
- (979) 207-4000
- Fax
- (979) 207-4562
- NPI assigned
- Jan 26, 2006
- Last updated
- Apr 22, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1055085 | TX | Primary |
Addresses
Primary practice location
800 Scott and White Dr
College Station, TX 77845-6440
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lbradway1504585@direct.sw.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1055085 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports, Back & Pain Mangement Clinic | Physical Therapist | Current | Accepting new patients |
| Emerelli, PLLC | Physical Therapist | Current | Accepting new patients |
| Scott & White Clinic | Current | Accepting new patients | |
| Scott & White Clinic | Current | Accepting new patients | |
| Paul V Bonarrigo | Past | Accepting new patients |
Locations
2011 E Villa Maria Rd
#A
Bryan, TX 77802
Phone (409) 776-2225
2011A E Villa Maria Rd
Bryan, TX 77802
Phone (409) 775-3728
2705 Osler Blvd
Bryan, TX 77802
Phone (979) 776-2225
2714 Osler Blvd
Bryan, TX 77802
Phone (979) 776-2225
800 Scott and White Dr
College Station, TX 77845
Phone (979) 207-3300
Interoperability endpoints
- lbradway1504585@direct.sw.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthopedic Physical Therapist
- Bryan, TX
- NPI 1275786469
-
dba Baylor Scott & White Clinic - Temple
- Internal Medicine Physician
- Temple, TX
- NPI 1093779704
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1649820796
-
- Internal Medicine Physician
- Pflugerville, TX
- NPI 1679691729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1932179306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "800-994-0371",
"fax_number": "254-215-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SCOTT AND WHITE DR",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778456440",
"telephone_number": "979-207-4000",
"fax_number": "979-207-4562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADWAY",
"first_name": "LEON",
"middle_name": "F.",
"name_suffix": "III",
"credential": "PHYSICIAL THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1055085",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lbradway1504585@direct.sw.org",
"affiliation": "N",
"address_1": "800 Scott and White Dr",
"city": "College Station",
"state": "TX",
"country_code": "US",
"postal_code": "778456440",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.