Contract Details
Ancillary Care Services
Facility name
Center For Disease Detection
Provider ID
P000003660
NPI
1033203393
Tax ID
232892142
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
11603 Crosswinds Way Suite 100
San Antonio, TX 78233
United States
County
Bexar
Phone
2105903033 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address