Provider First Line Business Practice Location Address:
9200 INWOOD ROAD STE. 201
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:
75220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-706-9545
Provider Business Practice Location Address Fax Number:
214-692-0803
Provider Enumeration Date:
10/03/2006