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NPI Code Detail

MEDICARE: DR. BRIAN RONALD SAUL D.C.

MEDICARE: DR. BRIAN RONALD SAUL D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NS0005XSports Physician Chiropractor9203TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18U3647OTHERTXBLUE CROSS BLUE SHIELD
25055041OTHERTXCIGNA

General Provider Information

NPI Number : 1982738159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN RONALD SAUL D.C.
Provider Business Mailing Address
First Line : 4634 CAMP BOWIE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-3744
Country : US
Telephone Number : 817-735-3839
Fax Number : 817-735-3837
Provider Business Practice Location Address
First Line : 4634 CAMP BOWIE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-3744
Country : US
Telephone Number : 817-735-3839
Fax Number : 817-735-3837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 09/03/2010

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