Provider First Line Business Practice Location Address:
2404 S EXPRESSWAY 83
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-365-3318
Provider Business Practice Location Address Fax Number:
210-690-2463
Provider Enumeration Date:
08/17/2009