Provider First Line Business Practice Location Address:
6343 FANNIN ST, JJL 447
Provider Second Line Business Practice Location Address:
EMERGENCY DEPARTMENT, UNIV OF TEXAS AT HOUSTON
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:
713-500-7834
Provider Business Practice Location Address Fax Number:
713-500-0758
Provider Enumeration Date:
07/22/2005