Provider First Line Business Practice Location Address:
566 VETERANS DR. SOUTH
Provider Second Line Business Practice Location Address:
TEXAS DETENTION CENTER
Provider Business Practice Location Address City Name:
PEARSALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-231-4701
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2014