Provider First Line Business Practice Location Address:
1821 HALE DRIVE
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-421-5959
Provider Business Practice Location Address Fax Number:
956-365-3007
Provider Enumeration Date:
11/16/2007