Provider First Line Business Practice Location Address:
TEN MEDICAL CENTER DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARENDON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79226-0300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-874-5221
Provider Business Practice Location Address Fax Number:
806-874-5619
Provider Enumeration Date:
02/29/2008