Provider First Line Business Practice Location Address:
2601 HOSPITAL BLVD
Provider Second Line Business Practice Location Address:
STE 117
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78405-1815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-884-8209
Provider Business Practice Location Address Fax Number:
361-882-6649
Provider Enumeration Date:
06/04/2007