Contract Details
Tasa
Facility name
Tasa
Provider ID
P000006501
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
1611 Spencer Hwy Suite D
South Houston, TX 77587
United States
County
Harris
Phone
7139438000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address