Provider First Line Business Practice Location Address:
4400 N INTERSTATE 35
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78218-5213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-691-8800
Provider Business Practice Location Address Fax Number:
210-691-8803
Provider Enumeration Date:
09/04/2006