Contract Details
Facility name
Deloache Chiropractic Health Center
Provider ID
P000004140
NPI
1265441240
Tax ID
760433111
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1107 Spring Cypress Rd Suite A
Spring, TX 77373
United States
County
Harris
Phone
2813509811 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address