Provider First Line Business Practice Location Address:
2200 E LEDBETTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75216-7408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-376-7050
Provider Business Practice Location Address Fax Number:
214-372-1434
Provider Enumeration Date:
07/16/2008