Contract Details
Ancillary Care Services
Facility name
Total Orthotic & Prosthetic Solutions
Provider ID
P000004294
NPI
1326379736
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
1393 George Dieter Drive Suite C
El Paso, TX 79936
United States
County
El Paso
Phone
9155950730 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address