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Contract Details
Ancillary Care Services
Facility name
Dumas Physical Therapy
Provider ID
P000004088
NPI
1235363979
Tax ID
264512338
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
515 East 1st Street
Dumas, TX 79029
United States
County
Moore
Phone
8069342634
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address