Provider First Line Business Practice Location Address:
UNIVERSITY OF TEXAS MEDICAL BR
Provider Second Line Business Practice Location Address:
301 UNIVERSITY BLVD
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77555-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-269-6700
Provider Business Practice Location Address Fax Number:
281-265-5159
Provider Enumeration Date:
12/01/2014