Healthcare Provider Details

I. General information

NPI: 1871708552
Provider Name (Legal Business Name): VICTORY INJURY CENTERS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 MATLOCK ROAD SUITE 204
ARLINGTON TX
76015
US

IV. Provider business mailing address

PO BOX 3445
CEDAR HILL TX
75106-3445
US

V. Phone/Fax

Practice location:
  • Phone: 817-419-9023
  • Fax: 817-419-4013
Mailing address:
  • Phone: 469-272-0088
  • Fax: 469-272-4576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number9203
License Number StateTX

VIII. Authorized Official

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