Contract Details
Ancillary Care Services
Facility name
Digi-Rad X-Ray Mobile
Provider ID
P000005251
NPI
1740516152
Tax ID
270806830
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
121 West Tyler Avenue
Harlingen, TX 78550
United States
County
Cameron
Phone
9564252666 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address