Provider First Line Business Practice Location Address:
1611 SPENCER HWY
Provider Second Line Business Practice Location Address:
SUITE H
Provider Business Practice Location Address City Name:
SOUTH HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77587-3772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-782-1800
Provider Business Practice Location Address Fax Number:
713-782-1847
Provider Enumeration Date:
12/22/2010