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Contract Details
American Eyecare PC
Facility name
American Eyecare PC
Provider ID
P000004762
NPI
1538258363
Tax ID
421213277
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2235 Ave L
Fort Madison, IA 52627
United States
County
Lee
Phone
3193722020
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address