Provider First Line Business Practice Location Address:
1402 E 8TH ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
WESLACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78596-6638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-968-6546
Provider Business Practice Location Address Fax Number:
956-968-2584
Provider Enumeration Date:
02/22/2012