Contract Details
Ancillary Care Services
Facility name
Hulen Chiropractic Clinic
Provider ID
P000004210
NPI
1295011336
Tax ID
453662569
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
7315 South Hulen Street
Fort Worth, TX 76133
United States
County
Tarrant
Phone
8173460453 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address