Nadia    Sledge    OD
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000003620
NPI
1013077163
Tax ID
203340247
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
5015 Westheimer Road Suite 2304
Houston, TX 77056
United States
County
Harris
Phone
7136234181 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address