Amy    Munroe    OD
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000006528
Tax ID
743050643
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Term Date
10/31/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
28301 Tomball Parkway 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