Contract Details
Ancillary Care Services
Facility name
Avalon Diagnostics
Provider ID
P000005248
NPI
1740458298
Tax ID
262027940
Effective Date
4/1/2012
Last Updated
10/23/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2009 Independence Drive Suite 103
Sherman, TX 75090
United States
County
Grayson
Phone
9038926496 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address