Parvin    Azhdarinia    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005439
NPI
1821267899
Tax ID
201099986
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
12000 Richmond Avenue Suite 330
Houston, TX 77082
United States
County
Harris
Phone
7133340530 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address