Contract Details
Ancillary Care Services
Facility name
Structure Chiropractic & Physical Therapy
Provider ID
P000003594
NPI
1003068917
Tax ID
263316503
Effective Date
4/1/2012
Last Updated
10/25/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
4508 Legacy Drive Suite 200
Plano, TX 75024
United States
County
Collin
Phone
2143774833 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address