Rick    Smith    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005788
NPI
1992788079
Tax ID
201514246
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
2901 South Georgia Street
Amarillo, TX 79109
United States
County
Randall
Phone
8063423333 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address