Contract Details
Ancillary Care Services
Facility name
Flood Spine Clinic
Provider ID
P000005232
NPI
1730458043
Tax ID
453237593
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
9219 Katy Freeway Suite 298
Houston, TX 77024
United States
County
Harris
Phone
7139654748 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address