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Contract Details
Universal MRI & Diagnostics
Facility name
Universal Town & Country MRI
Provider ID
P000005042
NPI
1669412219
Tax ID
760502924
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
10929 Katy Fwy
Houston, TX 77079
United States
County
Harris
Phone
7134655845
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address