Contract Details
Ancillary Care Services
Facility name
Baaxten Imaging Center
Provider ID
P000005488
NPI
1861449894
Tax ID
680595069
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
2302 South 77 Sunshine Strip Suite 101
Harlingen, TX 78550
United States
County
Cameron
Phone
9564122121 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address