Contract Details
A1 Imaging Centers LLC
Facility name
A1 Imaging of Fort Worth
Provider ID
P000004796
NPI
1548420698
Tax ID
262562595
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
7440 Oakmont Blvd
Fort Worth, TX 76132
United States
County
Tarrant
Phone
8172942400 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address