Contract Details
Ancillary Care Services
Facility name
Capital Toxicology
Provider ID
P000004844
NPI
1568696185
Tax ID
264832166
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
9417 Brodie Lane
Austin, TX 78748
United States
County
Travis
Phone
5126109955 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address