Provider Demographics
NPI:1225338783
Name:NATURAL HEALTH CHIROPRACTIC SPORT & SPINE
Entity Type:Organization
Organization Name:NATURAL HEALTH CHIROPRACTIC SPORT & SPINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-735-3839
Mailing Address - Street 1:4634 CAMP BOWIE BLVD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-3744
Mailing Address - Country:US
Mailing Address - Phone:817-735-3839
Mailing Address - Fax:817-735-3837
Practice Address - Street 1:4634 CAMP BOWIE BLVD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-3744
Practice Address - Country:US
Practice Address - Phone:817-735-3839
Practice Address - Fax:817-735-3837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9203111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty