Dyba Syed    Kalyani    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005087
NPI
1689656134
Tax ID
204230967
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
4712 Dexter Drive Suite 100
Plano, TX 75093
United States
County
Collin
Phone
9726123800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address