Leslie    Maloy    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004030
NPI
1215177829
Tax ID
263570397
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5323 Spring Valley Road Suite 100
Dallas, TX 75254
United States
County
Dallas
Phone
9729807131 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address