Provider First Line Business Practice Location Address:
625 E. 12TH STREET
Provider Second Line Business Practice Location Address:
MARKET SQUARE
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-541-9491
Provider Business Practice Location Address Fax Number:
956-544-3257
Provider Enumeration Date:
04/27/2006