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Get Texas Department Of Insurance, Division Of Workers' Compensation Medical Fee Dispute Resolution

INGS AND DECISION PART I: GENERAL INFORMATION A Requestor s Name and Address: SUMMIT REHABILITATON CENTERS C/O THE MORRIS LAW FIRM 702 S BECKLEY AVE DALLAS TX 75203 MFDR Tracking #: M4-07-0949-01 DWC Claim #: Injured Employee: Respondent Name and Box #: Date of Injury: Employer Name: American Home Assurance Co. Box #: 19 Insurance Carrier #: PART II: REQUESTOR S POSITION SUMMARY AND PRINCIPLE DOCUMENTATION Requestor s Position Summary: DOS 3/10/06 though 4/24/06 and 7/5/06: All.

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