Provider First Line Business Practice Location Address: 
5200 HARRY HINES BLVD
    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: 
75235-7709
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
214-590-8000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
05/03/2021