Provider First Line Business Practice Location Address:
6565 FANNIN ST.
Provider Second Line Business Practice Location Address:
METHODIST HOSPITAL
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-393-1140
Provider Business Practice Location Address Fax Number:
972-393-7933
Provider Enumeration Date:
12/16/2005