Robert    Chavana    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005435
NPI
1821152398
Tax ID
742557132
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
1200 South 10th Avenue
Edinburg, TX 78539
United States
County
Hidalgo
Phone
9563836330 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address