Provider First Line Business Practice Location Address:
512 EAST EDINBURG AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELSA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-262-9719
Provider Business Practice Location Address Fax Number:
956-262-9702
Provider Enumeration Date:
07/29/2013