Provider First Line Business Practice Location Address:
3551 ROGER BROOKE DR., INTERNAL MEDICINE RESIDENCY
Provider Second Line Business Practice Location Address:
SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-M
Provider Business Practice Location Address City Name:
JBSA-FORT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234-4504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-916-5910
Provider Business Practice Location Address Fax Number:
210-916-2077
Provider Enumeration Date:
03/06/2017