Provider First Line Business Practice Location Address:
3800 UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75205-1711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-987-5380
Provider Business Practice Location Address Fax Number:
214-987-5384
Provider Enumeration Date:
03/08/2007