Provider First Line Business Practice Location Address:
7541 US HIGHWAY 87 E,
Provider Second Line Business Practice Location Address:
SUITE #1
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-648-9900
Provider Business Practice Location Address Fax Number:
210-648-9902
Provider Enumeration Date:
11/04/2005