Majel  A  Alexander    OD
Contract Details
Facility name
Provider ID
P000003980
NPI
1184775876
Tax ID
900085017
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
20022 Hwy 59 North at FM 1960
Humble, TX 77338
United States
County
Harris
Phone
2815402688 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address