Provider First Line Business Practice Location Address:
27689 BAKER POTTS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78552-3755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-412-2002
Provider Business Practice Location Address Fax Number:
956-412-2879
Provider Enumeration Date:
02/18/2009