Provider First Line Business Practice Location Address:
5300 HOUSTON SCHOOL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75241-1219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-372-1496
Provider Business Practice Location Address Fax Number:
214-374-7333
Provider Enumeration Date:
09/20/2006