Jeff    Connors    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000003808
NPI
1093829129
Tax ID
571229591
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1304 Glade Road Suite 200
Colleyville, TX 76034
United States
County
Tarrant
Phone
8174287246 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address