Celeste  M  Borchers    DPM
Contract Details
Facility name
Provider ID
P000003902
NPI
1144253022
Tax ID
870757769
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
730 North Maln St Suite 819
San Antonio, TX 78205
United States
County
Bexar
Phone
2104450300 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address