Provider First Line Business Practice Location Address:
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CTR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PLASTIC SURGERY 1801 INWOOD ROAD
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-9132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-648-8602
Provider Business Practice Location Address Fax Number:
214-648-2550
Provider Enumeration Date:
05/31/2012