James    Hatfield    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004462
NPI
1407856909
Tax ID
742425123
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
1004 East Houston Street
Beeville, TX 78102
United States
County
Bee
Phone
3613582578 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address