Provider First Line Business Practice Location Address:
5323 HARRY HINES BLVD.
Provider Second Line Business Practice Location Address:
UT SOUTWESTERN OTOLARYNGOLOGY
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
45229-9035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-648-2972
Provider Business Practice Location Address Fax Number:
214-648-9122
Provider Enumeration Date:
09/15/2006