Provider First Line Business Practice Location Address:
5909 HARRY HINES BLVD.
Provider Second Line Business Practice Location Address:
UT SOUTHWESTERN MEDICAL CENTER, PHARMACY
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-9236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-645-1075
Provider Business Practice Location Address Fax Number:
214-645-1074
Provider Enumeration Date:
11/06/2006