Contract Details
Facility name
Tasa
Provider ID
P000003658
NPI
1033163639
Tax ID
760325252
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
14770 Memorial Dr Suite 220
Houston, TX 77079
United States
County
Harris
Phone
2814935535 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address