Brian    Masters    DC
Contract Details
Facility name
Provider ID
P000005338
NPI
1780792812
Tax ID
752912575
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
1224 West Walker
Breckenridge, TX 76424
United States
County
Stephens
Phone
2545593880 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address