Contract Details
Ancillary Care Services
Facility name
Gyn Path Services
Provider ID
P000005303
NPI
1770575938
Tax ID
742258912
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
8815 Dyer Street Suite 200
El Paso, TX 79904
United States
County
El Paso
Phone
9157558478 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address