Provider First Line Business Practice Location Address:
15714 HUEBNER RD
Provider Second Line Business Practice Location Address:
BLDG #3
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-447-3000
Provider Business Practice Location Address Fax Number:
210-447-3001
Provider Enumeration Date:
06/14/2006