Provider First Line Business Practice Location Address:
5001 BARKLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77017-3813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-772-9169
Provider Business Practice Location Address Fax Number:
713-649-5164
Provider Enumeration Date:
10/30/2007