Provider First Line Business Practice Location Address:
UNIVERSITY OF TEXAS MEDICAL
Provider Second Line Business Practice Location Address:
301 UNIVERSITY BOULEVARD
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-772-2436
Provider Business Practice Location Address Fax Number:
409-772-9532
Provider Enumeration Date:
06/15/2012