Healthcare Provider Details

I. General information

NPI: 1063635415
Provider Name (Legal Business Name): METROPLEX REHAB & SPORTS INJURY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 MATLOCK RD STE 204
ARLINGTON TX
76015-3616
US

IV. Provider business mailing address

3602 MATLOCK RD STE 204
ARLINGTON TX
76015-3616
US

V. Phone/Fax

Practice location:
  • Phone: 817-419-9023
  • Fax: 817-419-4013
Mailing address:
  • Phone: 817-419-9023
  • Fax: 817-419-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9203
License Number StateTX

VIII. Authorized Official

Name: BRIAN R SAUL
Title or Position: PROPRIETOR
Credential: D.C.
Phone: 469-272-0088