Provider First Line Business Practice Location Address:
7220 LOUIS PASTEUR DR
Provider Second Line Business Practice Location Address:
STE 160
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-9222
Provider Business Practice Location Address Fax Number:
210-614-9333
Provider Enumeration Date:
06/18/2005