Provider First Line Business Practice Location Address:
UTMB DEPARTMENT OF PEDIATRICS
Provider Second Line Business Practice Location Address:
3.300 CHILDREN'S HOSPITAL, 301 UNIVERSITY BLVD.
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77555-0351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-772-1011
Provider Business Practice Location Address Fax Number:
409-772-5208
Provider Enumeration Date:
10/17/2006