Provider First Line Business Practice Location Address:
5920 FOREST PARK RD STE 601
Provider Second Line Business Practice Location Address:
UT SOUTHWESTERN/PARKLAND FAMILY MEDICINE CLINIC
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75235-6411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-266-0312
Provider Business Practice Location Address Fax Number:
214-266-0330
Provider Enumeration Date:
07/25/2006