Provider First Line Business Practice Location Address:
6720 BERTNER AVENUE
Provider Second Line Business Practice Location Address:
CHI BAYLOR ST LUKE HOSPITAL
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-3411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-355-1000
Provider Business Practice Location Address Fax Number:
713-798-0111
Provider Enumeration Date:
12/13/2008