Contract Details
Ancillary Care Services
Facility name
River Ranch Radiology
Provider ID
P000003727
NPI
1063428472
Tax ID
742283108
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
711 West 38th Street Suite D-1
Austin, TX 78705
United States
County
Travis
Phone
5124549597 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address