Provider First Line Business Practice Location Address: 
4550 POST OAK PLACE DR
    Provider Second Line Business Practice Location Address: 
STE 141
    Provider Business Practice Location Address City Name: 
HOUSTON
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
77027-3106
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
713-629-0220
    Provider Business Practice Location Address Fax Number: 
713-629-0760
    Provider Enumeration Date: 
10/03/2006