Provider First Line Business Practice Location Address:
17745 US EXPRESSWAY 83
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-440-9729
Provider Business Practice Location Address Fax Number:
956-440-8882
Provider Enumeration Date:
07/28/2006