Provider First Line Business Practice Location Address:
1706 N ED CAREY DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-622-3157
Provider Business Practice Location Address Fax Number:
956-622-3409
Provider Enumeration Date:
08/16/2011