Provider First Line Business Practice Location Address:
1801 N ED CAREY DR
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-757-2497
Provider Business Practice Location Address Fax Number:
830-757-0489
Provider Enumeration Date:
12/21/2011