Sean    Scoggin    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000003724
NPI
1053647172
Tax ID
271174692
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
5850 Town And Country Boulevard Suite 701
Frisco, TX 75034
United States
County
Denton
Phone
2147056100 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address