Organization Active NPI

Victory Chiropractic LLC

  • Chiropractor
  • San Marcos, TX
National Provider Identifier
1063205052
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VICTORY CHIROPRACTIC LLC
Practice address
120 Riverwalk Dr Ste 308
San Marcos, TX 78666-5597
Phone
(425) 864-3004
NPI assigned
May 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eduardo Francisco Duran, DCNPI 1710773577
Title
President
Phone
(425) 864-3004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

120 Riverwalk Dr Ste 308
San Marcos, TX 78666-5597

Mailing address

436 Chaste Tree Dr
San Marcos, TX 78666-4993
Phone (425) 864-3004

Other identifiers 1

IdentifierTypeStateIssuer
1710773577MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250718000935 TX Part B Supplier - Clinic/Group Practice 5092221903 Receives reassigned benefits from 1 practitioner
Practice locations: San Marcos, TX

National Provider Directory

National Provider Directory

Locations

120 Riverwalk Dr
Ste 308
San Marcos, TX 78666
Phone (425) 864-3004

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1063205052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CHASTE TREE DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786664993",
            "telephone_number": "425-864-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RIVERWALK DR STE 308",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786665597",
            "telephone_number": "425-864-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "DURAN",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-864-3004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710773577",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.