Provider First Line Business Practice Location Address:
1508 E. BUS HWY 83
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
WESLACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78596
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-969-2785
Provider Business Practice Location Address Fax Number:
956-969-2780
Provider Enumeration Date:
10/30/2006