Contract Details
Cleburne Diagnostic Imaging
Facility name
SMR Diagnostics Ltd
Provider ID
P000005598
NPI
1912017401
Tax ID
752966093
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
505 North Ridgeway Dr Suite 252
Cleburne, TX 76033
United States
County
Johnson
Phone
8175175665 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address