Provider First Line Business Practice Location Address:
UT SOUTHWESTERN MEDICAL CENTER, DEPARTMENT OF PLASTIC S
Provider Second Line Business Practice Location Address:
1801 INWOOD ROAD
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-9132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-645-3104
Provider Business Practice Location Address Fax Number:
214-645-3148
Provider Enumeration Date:
06/07/2024