Provider First Line Business Practice Location Address:
2911 MEDICAL ARTS ST
Provider Second Line Business Practice Location Address:
BLDG 2 ATTN: AUSTIN SURGICAL CLINIC ASSN
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78705-3376
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-478-3402
Provider Business Practice Location Address Fax Number:
512-478-7114
Provider Enumeration Date:
07/08/2005