Contract Details
Ancillary Care Services
Facility name
Caldwell Prosthetics & Orthotics
Provider ID
P000004180
NPI
1275675035
Tax ID
208228655
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
330 Industrial Boulevard Suite 110
McKinney, TX 75069
United States
County
Collin
Phone
9725487707 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address