Provider First Line Business Practice Location Address:
10606 HEMPSTEAD HWY
Provider Second Line Business Practice Location Address:
STE 144
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-812-8277
Provider Business Practice Location Address Fax Number:
713-812-8255
Provider Enumeration Date:
09/19/2005