Kent    Rice    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005365
NPI
1790857852
Tax ID
465940137
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
11514 Fallbrook Drive
Houston, TX 77065
United States
County
Harris
Phone
2819559946 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address