Contract Details
Ancillary Care Services
Facility name
The Brace Center
Provider ID
P000005424
NPI
1821022088
Tax ID
752269249
Effective Date
4/1/2012
Last Updated
11/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1600 Central Drive Suite 157
Bedford, TX 76022
United States
County
Tarrant
Phone
8172670909 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address