Provider First Line Business Practice Location Address:
2601 HOSPITAL BLVD STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78405-1858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-883-5003
Provider Business Practice Location Address Fax Number:
361-882-6842
Provider Enumeration Date:
12/28/2006