Provider First Line Business Practice Location Address:
5959 HARRY HINES BLVD
Provider Second Line Business Practice Location Address:
ROOM HP5.520G
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-8887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-645-8183
Provider Business Practice Location Address Fax Number:
214-645-6294
Provider Enumeration Date:
04/06/2007