Provider First Line Business Practice Location Address:
12000 MCCREE RD
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:
75238-3275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-341-0422
Provider Business Practice Location Address Fax Number:
241-341-0422
Provider Enumeration Date:
01/27/2006