Provider First Line Business Practice Location Address:
590 MEDICAL CENTER RD
Provider Second Line Business Practice Location Address:
CARL R. DARNALL ARMY MEDICAL CENTER
Provider Business Practice Location Address City Name:
FORT CAVAZOS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-261-7193
Provider Business Practice Location Address Fax Number:
334-255-7710
Provider Enumeration Date:
04/26/2010