Provider First Line Business Practice Location Address:
1138 E EXPRESSWAY 83
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
PHARR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78577-6518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-283-1253
Provider Business Practice Location Address Fax Number:
956-781-4973
Provider Enumeration Date:
01/11/2007