Provider First Line Business Practice Location Address:
6550 FANNIN ST
Provider Second Line Business Practice Location Address:
THE METHODIST HOSPITAL, SM 1661
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-2717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-441-6160
Provider Business Practice Location Address Fax Number:
713-790-2898
Provider Enumeration Date:
01/15/2007