Contract Details
Ancillary Care Services
Facility name
Optimum Therapy
Provider ID
P000005194
NPI
1720059124
Tax ID
742709256
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
2624 North McColl Road
McAllen, TX 78501
United States
County
Hidalgo
Phone
9564247885 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address