Provider First Line Business Practice Location Address:
3818 BRANDT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-522-7140
Provider Business Practice Location Address Fax Number:
713-522-9221
Provider Enumeration Date:
10/02/2006