Contract Details
Ancillary Care Services
Facility name
Quality Care Sleep Diagnostics
Provider ID
P000003789
NPI
1083776165
Tax ID
611415935
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
1620 Grand Avenue Parkway Suite 110
Pflugerville, TX 78660
United States
County
Travis
Phone
5124525111 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address