Provider First Line Business Practice Location Address:
9209 ELAM RD STE 100
Provider Second Line Business Practice Location Address:
ROOSEVELT TAYLOR JR MD
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75217-7360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-391-3700
Provider Business Practice Location Address Fax Number:
214-391-7195
Provider Enumeration Date:
12/01/2006