Provider First Line Business Practice Location Address:
8538 IH-35 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-682-2020
Provider Business Practice Location Address Fax Number:
210-682-2021
Provider Enumeration Date:
10/25/2008