Provider Demographics
NPI:1063635415
Name:METROPLEX REHAB & SPORTS INJURY
Entity type:Organization
Organization Name:METROPLEX REHAB & SPORTS INJURY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
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 1:3602 MATLOCK RD
Mailing Address - Street 2:STE 204
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3616
Mailing Address - Country:US
Mailing Address - Phone:817-419-9023
Mailing Address - Fax:817-419-4013
Practice Address - Street 1:3602 MATLOCK RD
Practice Address - Street 2:STE 204
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3616
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:2007-04-11
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty