Christine    Castillo    OD
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005334
NPI
1780747279
Tax ID
730085017
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
6737 Stella Link Road
Houston, TX 77005
United States
County
Harris
Phone
7134321137 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address