Contract Details
Ancillary Care Services
Facility name
Elite Performance
Provider ID
P000004313
NPI
1336458546
Tax ID
273337848
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
5119 South McColl Road
Edinburg, TX 78539
United States
County
Hidalgo
Phone
8552885115 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address