Provider First Line Business Practice Location Address:
6431 FANNIN STREET
Provider Second Line Business Practice Location Address:
MSB 7.154 DEPARTMENT NEUROSURGERY/NEUROCRITICAL CARE
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-982-1152
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2019