Provider First Line Business Practice Location Address:
4610 E CROSSTIMBERS ST
Provider Second Line Business Practice Location Address:
KIPP DREAM PREP ACADEMY
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77016-6337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-636-6082
Provider Business Practice Location Address Fax Number:
713-523-4897
Provider Enumeration Date:
10/10/2012