Provider First Line Business Practice Location Address:
SCOTT & WHITE HEALTHCARE MEMORIAL
Provider Second Line Business Practice Location Address:
MS-01-512, 201 S 31ST ST
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76508-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-713-4850
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2012