Vanessa    Vajdos    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004594
NPI
1457512733
Tax ID
467968341
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
6781 FM 1102
New Braunfels, TX 78132
United States
County
Comal
Phone
5123460271 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address