Provider First Line Business Practice Location Address:
6431 FANNIN ST RM 6.100
Provider Second Line Business Practice Location Address:
UNIV OF TEXAS HEALTH SCI CTR - MEDICAL GENETICS
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-1501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-500-7072
Provider Business Practice Location Address Fax Number:
713-500-0693
Provider Enumeration Date:
10/17/2005