Provider First Line Business Practice Location Address:
1652 PAT BOOKER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIVERSAL CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78148-3433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-943-9100
Provider Business Practice Location Address Fax Number:
210-943-9200
Provider Enumeration Date:
04/08/2026