Provider First Line Business Practice Location Address:
8300 TEZEL RD
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:
78254-3016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-422-7313
Provider Business Practice Location Address Fax Number:
210-681-5079
Provider Enumeration Date:
12/26/2006