Provider First Line Business Practice Location Address: 
2222 WELBORN ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
DALLAS
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
75219-3924
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
214-559-5000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
07/06/2007