Provider First Line Business Practice Location Address: 
8850 LONG POINT RD
    Provider Second Line Business Practice Location Address: 
PATHOLOGY DEPARTMENT
    Provider Business Practice Location Address City Name: 
HOUSTON
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
77055-3006
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
713-468-0738
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
12/15/2006