Provider First Line Business Practice Location Address:
3551 ROGER BROOKE DR
Provider Second Line Business Practice Location Address:
DEPT. OF EMERG MED.-SAN ANTONIO MILITARY MEDICAL CENTER
Provider Business Practice Location Address City Name:
FT. SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-834-5014
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2009