Provider First Line Business Practice Location Address:
UT SOUTHWESTERN 1801 INWOOD ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-448-7635
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/20/2016