Chase    Lindsey    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004384
NPI
1376697995
Tax ID
202731067
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
820 East Villa Maria Road
Bryan, TX 77802
United States
County
Brazos
Phone
9797792273 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address