Nancy    Zimmerman    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004299
NPI
1336200088
Tax ID
742649507
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
98 East Price Road
Brownsville, TX 78521
United States
County
Cameron
Phone
9565445513 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address