Contract Details
Ancillary Care Services
Facility name
Cook Hearing and Balance
Provider ID
P000003778
NPI
1083701890
Tax ID
161751172
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
601 East Whitestone Boulevard Suite 712
Cedar Park, TX 78613
United States
County
Williamson
Phone
5122602665 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address