Contract Details
Ancillary Care Services
Facility name
Dallas Eye Associates
Provider ID
P000004692
NPI
1508041039
Tax ID
751415534
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
6500 Greenville Avenue Suite 150
Dallas, TX 75206
United States
County
Dallas
Phone
2146921901 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address