Rubin  V  Urban    OD
Contract Details
Facility name
Provider ID
P000005676
NPI
1942444674
Tax ID
760500576
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
28301 Tomball Pkwy Suite 700
Tomball, TX 77375
United States
County
Harris
Phone
2813512020 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address