Provider First Line Business Practice Location Address:
8002 W. EXPWAY 83
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-230-2805
Provider Business Practice Location Address Fax Number:
956-425-6921
Provider Enumeration Date:
05/21/2008