Contract Details
Facility name
Medical Center Cath Lab LLP
Provider ID
P000004611
NPI
1467534529
Tax ID
760509077
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
6550 Fannin St Suite 333
Houston, TX 77030
United States
County
Harris
Phone
7137905721 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Cardiac Monitoring
Map
Address