Provider First Line Business Practice Location Address:
1504 TAUB LOOP
Provider Second Line Business Practice Location Address:
PHYSICIAN SERVICES
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-873-2314
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2009