Contract Details
Facility name
Metroplex Imaging LP
Provider ID
P000005129
NPI
1699783464
Tax ID
203765351
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
17950 Preston Rd Suite 120
Dallas, TX 75252
United States
County
Collin
Phone
9727586900 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address