Contract Details
Ancillary Care Services
Facility name
Brownsville Advanced Medical Imaging Center
Provider ID
P000005265
NPI
1750471264
Tax ID
721534898
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
1260 West Price Road
Brownsville, TX 78520
United States
County
Cameron
Phone
9565442264 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address