Provider First Line Business Practice Location Address:
6200 UTSA BLVD
Provider Second Line Business Practice Location Address:
100
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78249-1617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-8200
Provider Business Practice Location Address Fax Number:
210-614-8258
Provider Enumeration Date:
06/27/2006