Provider First Line Business Practice Location Address:
7000 FANNIN STREET SUITE 1620
Provider Second Line Business Practice Location Address:
UNIVERSITY OF TEXAS HEALTH SCIENCE
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-500-3267
Provider Business Practice Location Address Fax Number:
713-500-3263
Provider Enumeration Date:
08/28/2006