Contract Details
Ancillary Care Services
Facility name
Westover Clinic
Provider ID
P000006596
Tax ID
742936369
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
3903 Wiseman Boulevard Suite 311
San Antonio, TX 78251
United States
County
Bexar
Phone
2106816681 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address