Provider First Line Business Practice Location Address:
HEALTH 2, 4849 CALHOUN ROAD
Provider Second Line Business Practice Location Address:
ROOM 2005
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77204-3019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-743-5151
Provider Business Practice Location Address Fax Number:
713-743-5164
Provider Enumeration Date:
04/15/2015