Contract Details
Ancillary Care Services
Facility name
Numed Imaging Center
Provider ID
P000004737
NPI
1528040664
Tax ID
752577465
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
150 River North Boulevard
Stephenville, TX 76401
United States
County
Erath
Phone
2549686051 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address