Provider First Line Business Practice Location Address:
TEXAS CHILDREN'S HOSPITAL
Provider Second Line Business Practice Location Address:
6621 FANNIN STREET, MC-19345
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-826-5642
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2006