Contract Details
Ancillary Care Services
Facility name
Friendswood Vision
Provider ID
P000005706
NPI
1952680142
Tax ID
455239249
Effective Date
7/26/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
132 West Parkwood Avenue
Friendswood, TX 77546
United States
County
Galveston
Phone
2818190132 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address