Provider First Line Business Practice Location Address:
7400 MERTON MINTER BLVD
Provider Second Line Business Practice Location Address:
STVHCS PSYCHOLOGY SERVICE 116B
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-616-8275
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2015