Contract Details
Ancillary Care Services
Facility name
Visionary Medical Imaging
Provider ID
P000003848
NPI
1114988482
Tax ID
201816953
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
1103 Sara Swamy Drive
Sherman, TX 75090
United States
County
Grayson
Phone
9038701767 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address