Provider First Line Business Practice Location Address:
1010 WEST AVENUE B
Provider Second Line Business Practice Location Address:
TEXAS A&M HEALTH SCIENCE CENTER, MSC 131
Provider Business Practice Location Address City Name:
KINGSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-593-4271
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2009