Provider First Line Business Practice Location Address:
4800 ALBERTA DR
Provider Second Line Business Practice Location Address:
DEPT PEDIATRICS; TEXAS TECH HEALTH SCIENCES CTR
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-545-6921
Provider Business Practice Location Address Fax Number:
915-545-6975
Provider Enumeration Date:
11/10/2006