Shawn  M  Muldoon    OD
Contract Details
Facility name
Provider ID
P000004336
NPI
1356344618
Tax ID
760650326
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
5874 Westheimer Rd
Houston, TX 77057
United States
County
Harris
Phone
7139742020 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address