Contract Details
Ancillary Care Services
Facility name
Somnodiagnostics
Provider ID
P000005027
NPI
1659421964
Tax ID
710852907
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
106 Ridgeway Street Suite A
Hot Springs, AR 71901
United States
County
Garland
Phone
5013210547 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address