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Contract Details
Ancillary Care Services
Facility name
North Texas Sleep Disorders Center
Provider ID
P000004425
NPI
1396748836
Tax ID
752521859
Effective Date
4/1/2012
Last Updated
11/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1213 Bent Oaks Court
Denton, TX 76210
United States
County
Denton
Phone
9405911496
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
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Address