Contract Details
Ancillary Care Services
Facility name
River Ranch Radiology
Provider ID
P000006462
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
15808 Ranch Road 620 North Suite 110
Austin, TX 78717
United States
County
Williamson
Phone
5124549597 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address