Provider First Line Business Practice Location Address:
BAYLOR HOSPITAL - 3 HOB
Provider Second Line Business Practice Location Address:
3500 GASTON AVENUE
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-820-2806
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2006