Contract Details
Ancillary Care Services
Facility name
New Life Brace & Limb
Provider ID
P000006518
Tax ID
204877969
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
1413 Avenue G
Bay City, TX 77414
United States
County
Matagorda
Phone
2813165805 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address