Contract Details
Ancillary Care Services
Facility name
Upper Valley Interventional Radiology
Provider ID
P000005497
NPI
1861571929
Tax ID
460519691
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
905 East Esperanza Avenue
McAllen, TX 78501
United States
County
Hidalgo
Phone
9566310124 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address