Provider First Line Business Practice Location Address:
7400 MERTON MINTER BOULEVARD
Provider Second Line Business Practice Location Address:
MEDICAL STAFF OFFICE 11M, SOUTH TEXAS VETERANS HCS
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-616-8380
Provider Business Practice Location Address Fax Number:
210-616-8383
Provider Enumeration Date:
06/01/2006