Provider First Line Business Practice Location Address:
11723 FM 580 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEMPNER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-734-1710
Provider Business Practice Location Address Fax Number:
512-556-4647
Provider Enumeration Date:
10/04/2005