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Contract Details
Ancillary Care Services
Facility name
Lone Star Eye
Provider ID
P000004950
NPI
1619289873
Tax ID
273135992
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
2700 Barton Creek Boulevard Suite 110
Austin, TX 78735
United States
County
Travis
Phone
5123287300
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
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Address