Provider First Line Business Practice Location Address:
2401 N ED CAREY DR
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-425-7800
Provider Business Practice Location Address Fax Number:
956-425-7801
Provider Enumeration Date:
10/25/2005