Member Login
Home
About Us
Become a Provider
Become a Member
Administrators
Contact Us
Member Login
Contract Details
Ancillary Care Services
Facility name
Dynamic Children Therapy Services
Provider ID
P000004346
NPI
1356654461
Tax ID
272823055
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
2605 West Mile 5 Road
Mission, TX 78574
United States
County
Hidalgo
Phone
9565810987
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address