Provider First Line Business Practice Location Address:
5555 NORTH LAMAR BLVD BLDG D SUITE 125
Provider Second Line Business Practice Location Address:
SETON FAMILY OF HOSPITALS
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-324-1891
Provider Business Practice Location Address Fax Number:
512-324-1396
Provider Enumeration Date:
09/16/2006