Contract Details
Ancillary Care Services
Facility name
South Texas Sleep Disorder Clinic
Provider ID
P000003923
NPI
1154480085
Tax ID
200251801
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1201 East Ridge Road Suite E
McAllen, TX 78503
United States
County
Hidalgo
Phone
9566828685 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address