Contract Details
Ancillary Care Services
Facility name
Pulmonary Home Care
Provider ID
P000003967
NPI
1184618357
Tax ID
741791070
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
3505 South Dairy Ashford Street Suite 185
Houston, TX 77082
United States
County
Harris
Phone
2816790877 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address