Provider First Line Business Practice Location Address:
1600 E US HIGHWAY 83
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
WESLACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78596-6613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-969-8903
Provider Business Practice Location Address Fax Number:
956-969-8903
Provider Enumeration Date:
08/25/2005