Contract Details
Facility name
Campbell Chiropractic Clinic
Provider ID
P000003879
NPI
1134136682
Tax ID
760613032
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
4501 Magnolia Cove Suite 108
Kingwood, TX 77345
United States
County
Harris
Phone
2813587777 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address