Contract Details
Facility name
Spinal Aid Center
Provider ID
P000004358
NPI
1366484008
Tax ID
262986039
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
3103 Southeast Military Dr Suite 105
San Antonio, TX 78223
United States
County
Bexar
Phone
9035262225 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address