Contract Details
Ancillary Care Services
Facility name
Corpus Christi Sleep Center
Provider ID
P000004992
NPI
1639355753
Tax ID
562342089
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
100.00
Location Details
Address
13701 Northwest Boulevard Suite D-3
Corpus Christi, TX 78410
United States
County
Nueces
Phone
3612253954 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address