Contract Details
Ancillary Care Services
Facility name
Medwheels
Provider ID
P000005123
NPI
1699727842
Tax ID
203011832
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1322 East Houston Street
San Antonio, TX 78205
United States
County
Bexar
Phone
2105339457 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address