Leandro  A  Barcacel    OD
Contract Details
Facility name
Provider ID
P000004033
NPI
1215903620
Tax ID
760227044
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
15999 City Walks Suite 270
Sugar Land, TX 77479
United States
County
Fort Bend
Phone
2812770152 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address