Provider First Line Business Practice Location Address:
1401 E WASHINGTON ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78520-5740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-542-5647
Provider Business Practice Location Address Fax Number:
956-542-5648
Provider Enumeration Date:
11/28/2006