Jerry  D  Hyder    OD
Contract Details
Facility name
Provider ID
P000003689
NPI
1043334063
Tax ID
760333775
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
515 Bay Area Blvd Suite 300
Houston, TX 77058
United States
County
Harris
Phone
2814880066 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address