Provider First Line Business Practice Location Address:
18700 KATY FREEWAY
Provider Second Line Business Practice Location Address:
MEDICAL OFFICE BUILDING 3, SUITE 403
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-522-8444
Provider Business Practice Location Address Fax Number:
832-522-8445
Provider Enumeration Date:
03/28/2013