Provider First Line Business Practice Location Address:
1201 W 38TH ST
Provider Second Line Business Practice Location Address:
NEONATOLOGY OFFICE 8TH FLOOR
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-324-1086
Provider Business Practice Location Address Fax Number:
512-324-1089
Provider Enumeration Date:
10/15/2006