Contract Details
Facility name
Dallas Foot Center
Provider ID
P000005029
NPI
1659443935
Tax ID
752773139
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3300 Douglas Ave Suite B
Dallas, TX 75219
United States
County
Dallas
Phone
2145263336 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address