Contract Details
Ancillary Care Services
Facility name
Desert Imaging
Provider ID
P000004058
NPI
1225137078
Tax ID
742642478
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
122 West Castellano Drive
El Paso, TX 79912
United States
County
El Paso
Phone
9152274737 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address