Contract Details
Ancillary Care Services
Facility name
North Texas Chiropractic Clinic
Provider ID
P000004614
NPI
1467635029
Tax ID
201818870
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
81.00
Location Details
Address
638 Londonderry Lane
Denton, TX 76205
United States
County
Denton
Phone
9405658118 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address