Beatrice    Okons    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004566
NPI
1447490651
Tax ID
161675029
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
901 Beltline Road Suite 101
Garland, TX 75040
United States
County
Dallas
Phone
2143439990 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address