Contract Details
Ancillary Care Services
Facility name
Total Orthotic & Prosthetic Solutions
Provider ID
P000003728
NPI
1063458917
Tax ID
562405432
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
900 East Yandell Drive
El Paso, TX 79902
United States
County
El Paso
Phone
9155418677 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address