Provider First Line Business Practice Location Address:
204 SOUTH CASA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHARR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-787-9924
Provider Business Practice Location Address Fax Number:
956-782-9607
Provider Enumeration Date:
05/02/2007