Provider First Line Business Practice Location Address:
2929 CARLISLE ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75204-1084
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-348-5557
Provider Business Practice Location Address Fax Number:
214-348-5898
Provider Enumeration Date:
04/22/2009