Provider First Line Business Practice Location Address:
UNIV OF TEXAS SOUTHWESTERN MEDICAL CTR
Provider Second Line Business Practice Location Address:
5323 HARRY HINES BOULEVARD
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-648-5964
Provider Business Practice Location Address Fax Number:
214-648-1666
Provider Enumeration Date:
02/03/2009