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Organization
VICTORY CHIROPRACTIC AND PHYSICAL THERAPY
Active
Organization
VICTORY CHIROPRACTIC AND PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN NIMPHIUS DC (OWNER)
(817) 251-6767
Entity
Organization
Contact information
Practice address
200 E SOUTHLAKE BLVD, SUITE 10, SOUTHLAKE, TX 76092-6238
(817) 251-6767
(817) 251-6868
Mailing address
200 E SOUTHLAKE BLVD, SUITE 10, SOUTHLAKE, TX 76092-6238
(817) 251-6767
(817) 251-6868
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9184
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607138
BCBS
TX
Enumeration date
10/17/2012
Last updated
10/17/2012
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