Provider First Line Business Practice Location Address:
3551 ROGER BROOKE DRIVE, BLDG 3600
Provider Second Line Business Practice Location Address:
BROOKE ARMY MEDICAL CENTER - DEPT OF SURGERY
Provider Business Practice Location Address City Name:
FT. SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-916-1153
Provider Business Practice Location Address Fax Number:
210-916-2202
Provider Enumeration Date:
03/01/2006