Provider First Line Business Practice Location Address:
18400 KATY FREEWAY
Provider Second Line Business Practice Location Address:
MEDICAL BUILDING 1 - SUITE 560
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-522-3240
Provider Business Practice Location Address Fax Number:
281-578-2404
Provider Enumeration Date:
08/09/2006