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Contract Details
Ancillary Care Services
Facility name
Eye Q Vision
Provider ID
P000005623
NPI
1922060706
Tax ID
273991744
Effective Date
5/24/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
8380 Warren Parkway Suite 605
Frisco, TX 75034
United States
County
Denton
Phone
9726683131
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
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Address