Contract Details
Ancillary Care Services
Facility name
Cano Health & Rehab Clinic
Provider ID
P000005233
NPI
1740212943
Tax ID
432103836
Effective Date
9/27/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1528 South Buckner Boulevard
Dallas, TX 75217
United States
County
Dallas
Phone
2143919100 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address