Provider First Line Business Practice Location Address:
801 N 13TH ST STE 16A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-5073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-428-9020
Provider Business Practice Location Address Fax Number:
956-428-3436
Provider Enumeration Date:
11/01/2006