Contract Details
Ancillary Care Services
Facility name
Hands of Grace Medical Clinic
Provider ID
P000005815
NPI
1538417936
Tax ID
710992609
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
118 West Flack Street
Falfurrias, TX 78355
United States
County
Brooks
Phone
9566864040 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Urgent Care Facility
Map
Address