Contract Details
Ancillary Care Services
Facility name
Patrice Sylvain, SLP
Provider ID
P000005650
NPI
1932228905
Tax ID
434577087
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
14423 Brunswick Point Lane
Houston, TX 77047
United States
County
Harris
Phone
8323643394 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address