Provider First Line Business Practice Location Address:
1720 E HARRISON AVE
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-440-0551
Provider Business Practice Location Address Fax Number:
956-440-1942
Provider Enumeration Date:
11/15/2006