Mary    Colings    DC
Contract Details
Facility name
Provider ID
P000003955
NPI
1174619571
Tax ID
752689595
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
6750 North MacArthur Blvd Suite 331
Irving, TX 75039
United States
County
Dallas
Phone
9722567114 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address