Provider First Line Business Practice Location Address:
4500 SOUTH LANCASTER ROAD
Provider Second Line Business Practice Location Address:
SCI (128) / VA NORTH TEXAS HEALTH CARE SYSTEM
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-857-2208
Provider Business Practice Location Address Fax Number:
214-857-1759
Provider Enumeration Date:
10/07/2009