Contract Details
Ancillary Care Services
Facility name
All Valley Sleep Center
Provider ID
P000004400
NPI
1386685717
Tax ID
202953727
Effective Date
6/28/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1000 East Express 83
La Joya, TX 78560
United States
County
Hidalgo
Phone
9569715510 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address