Provider First Line Business Practice Location Address:
BAYLOR UNIVERSITY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
3500 GASTON AVE
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75246-2017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-361-2152
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2007