Provider First Line Business Practice Location Address:
8955 LONG POINT DR
Provider Second Line Business Practice Location Address:
C/O SPRING BRANCH HEALTH CARE CENTER
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-464-7625
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2007