Provider First Line Business Practice Location Address:
1315 E 6TH ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
WESLACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78596-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-968-9333
Provider Business Practice Location Address Fax Number:
956-973-0491
Provider Enumeration Date:
07/09/2006