Provider First Line Business Practice Location Address:
UT SOUTHWESTERN MEDICAL CENTER DEPT OF DERMATOLOGY
Provider Second Line Business Practice Location Address:
5323 HARRY HINES BLVD.
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-9069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-456-5030
Provider Business Practice Location Address Fax Number:
214-456-2744
Provider Enumeration Date:
11/21/2007