Contract Details
Ancillary Care Services
Facility name
Ortho Plus
Provider ID
P000004348
NPI
1366407132
Tax ID
742799731
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
7823 Fortune Drive
San Antonio, TX 78250
United States
County
Bexar
Phone
2105418568 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address