Contract Details
Facility name
East Loop Chiropractic
Provider ID
P000004321
NPI
1346265618
Tax ID
760523249
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
1140 Westmont Dr Suite 547
Houston, TX 77015
United States
County
Harris
Phone
7136747770 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address