Provider First Line Business Practice Location Address:
700 WALTER REED BLVD
Provider Second Line Business Practice Location Address:
MEDICAL PLAZA II, SUITE 301B
Provider Business Practice Location Address City Name:
GARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75042-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-485-2000
Provider Business Practice Location Address Fax Number:
972-272-2294
Provider Enumeration Date:
06/30/2006