Provider First Line Business Practice Location Address:
126 ZAMORA MEDICAL CIR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAGLE PASS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78852-5593
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-758-1149
Provider Business Practice Location Address Fax Number:
830-752-6037
Provider Enumeration Date:
02/19/2007