Provider First Line Business Practice Location Address:
9323 GARLAND RD
Provider Second Line Business Practice Location Address:
STE 111
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75218-3693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-328-7400
Provider Business Practice Location Address Fax Number:
214-328-7680
Provider Enumeration Date:
06/02/2005