Provider First Line Business Practice Location Address:
510 W TIDWELL RD
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77091-4339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-618-8616
Provider Business Practice Location Address Fax Number:
281-618-8612
Provider Enumeration Date:
06/28/2012