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Contract Details
Memorial MRI & Diagnostic, LLC
Facility name
Memorial Women's Center
Provider ID
P000006491
Tax ID
760677442
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
8800 Katy Fwy Suite 105
Houston, TX 77024
United States
County
Harris
Phone
7134613399
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address