Provider First Line Business Practice Location Address:
4301 S EXPRESSWAY 83
Provider Second Line Business Practice Location Address:
GOOD SAMARITAN CENTER
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-412-5826
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/10/2007