Contract Details
Facility name
Diagnostic Radiology of Houston
Provider ID
P000004757
NPI
1538193701
Tax ID
760535909
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
2600 North Gessner Suite 150
Houston, TX 77080
United States
County
Harris
Phone
7134258100 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address