Eric    Halsell    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004884
NPI
1588794671
Tax ID
462023371
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
501 North Main Street Suite G
Cleburne, TX 76033
United States
County
Johnson
Phone
8175562000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address