Provider First Line Business Practice Location Address:
1900 W SCHUNIOR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-984-6163
Provider Business Practice Location Address Fax Number:
956-943-5161
Provider Enumeration Date:
10/05/2006