Contract Details
Ancillary Care Services
Facility name
Precision Prosthetic
Provider ID
P000004362
NPI
1366585689
Tax ID
742926806
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1501 East Missouri Avenue
El Paso, TX 79902
United States
County
El Paso
Phone
9155442961 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address