Provider First Line Business Practice Location Address:
5402 LAWNDALE ST.
Provider Second Line Business Practice Location Address:
KIPP: 2 KIPP ROTATION
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-351-7360
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2013