Alexander    Pham    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000006537
Tax ID
270399110
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3112 North Jupiter Road
Garland, TX 75044
United States
County
Dallas
Phone
9724967070 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address