Provider First Line Business Practice Location Address:
12730 INTERSTATE HIGHWAY-10 WEST
Provider Second Line Business Practice Location Address:
UNIVERSITY SQUARE SHOPPING CENTER-SUITE 310
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-691-2022
Provider Business Practice Location Address Fax Number:
210-691-2152
Provider Enumeration Date:
02/21/2007