Brian    Hawkins    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004039
NPI
1215937677
Tax ID
741855746
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
1050 Heights Boulevard
Houston, TX 77008
United States
County
Harris
Phone
7138613603 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address