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Contract Details
Ancillary Care Services
Facility name
Pearle Vision Bunker Hill
Provider ID
P000003700
NPI
1043523129
Tax ID
263848810
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
9738 Katy Freeway Suite 500
Houston, TX 77055
United States
County
Harris
Phone
7134682424
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
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Address