Kent  R  Cooley    DC
Contract Details
Facility name
Provider ID
P000005119
NPI
1699707323
Tax ID
752797371
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
6605 Precinct Line Rd Suite 100B
North Richland Hills, TX 76182
United States
County
Tarrant
Phone
8172811995 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address