Provider First Line Business Practice Location Address:
9323 GARLAND RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75218-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-328-9948
Provider Business Practice Location Address Fax Number:
214-320-9260
Provider Enumeration Date:
03/27/2007