Contract Details
Facility name
Southeast Texas EMS
Provider ID
P000003994
NPI
1194770255
Tax ID
760689165
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
985 IH 10 North Suite 110G
Beaumont, TX 77706
United States
County
Jefferson
Phone
4093473111 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Ambulance, Land
Map
Address