Aaron    Horton    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005415
NPI
1811192511
Tax ID
204361350
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
4140 Heritage Trace Parkway Suite 300
Keller, TX 76244
United States
County
Tarrant
Phone
8177416500 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address