Contract Details
Ancillary Care Services
Facility name
Cardiosom of Dallas
Provider ID
P000003672
NPI
1033370275
Tax ID
113733629
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
8338 Sterling Street
Irving, TX 75063
United States
County
Dallas
Phone
2144411670 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address