Provider First Line Business Practice Location Address:
1919 LA BRANCH ST
Provider Second Line Business Practice Location Address:
ST. JOSEPH MEDICAL CENTER
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77002-8321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-756-5381
Provider Business Practice Location Address Fax Number:
713-756-4518
Provider Enumeration Date:
07/21/2006