Provider First Line Business Practice Location Address: 
8800 LONG POINT RD
    Provider Second Line Business Practice Location Address: 
DOW PHARMACY
    Provider Business Practice Location Address City Name: 
HOUSTON
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
77055-3025
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
713-722-7999
    Provider Business Practice Location Address Fax Number: 
713-722-7922
    Provider Enumeration Date: 
08/14/2006