Calvin    Nguyen    DC
Contract Details
Facility name
Provider ID
P000006484
Tax ID
412257296
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2741 Beltline Rd Suite 101
Carrollton, TX 75006
United States
County
Dallas
Phone
9724169355 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address