Richard    Hare    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004312
NPI
1336384866
Tax ID
263399052
Effective Date
4/1/2012
Last Updated
10/25/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
8116 Elk Mountain Trail
McKinney, TX 75070
United States
County
Collin
Phone
9729807131 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address