Benjamin    Beard    DC
Contract Details
Facility name
Provider ID
P000004891
NPI
1598712648
Tax ID
760621126
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3815 Reveille St
Houston, TX 77087
United States
County
Harris
Phone
7136492201 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address