Provider Demographics
NPI:1871708552
Name:VICTORY INJURY CENTERS LTD
Entity type:Organization
Organization Name:VICTORY INJURY CENTERS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-272-0088
Mailing Address - Street 1:PO BOX 3445
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106-3445
Mailing Address - Country:US
Mailing Address - Phone:469-272-0088
Mailing Address - Fax:469-272-4576
Practice Address - Street 1:3602 MATLOCK ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015
Practice Address - Country:US
Practice Address - Phone:817-419-9023
Practice Address - Fax:817-419-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9203111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U3647OtherBCBS