Provider First Line Business Practice Location Address:
200 E SAM HOUSTON ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
PHARR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78577-5440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-787-4800
Provider Business Practice Location Address Fax Number:
956-787-0067
Provider Enumeration Date:
02/27/2007