Provider First Line Business Practice Location Address:
1215 EAST COURT STREET
Provider Second Line Business Practice Location Address:
GUADALUPE REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
SEGUIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-401-7561
Provider Business Practice Location Address Fax Number:
830-379-4441
Provider Enumeration Date:
08/10/2006