Provider First Line Business Practice Location Address:
800 W CAMPBELL RD
Provider Second Line Business Practice Location Address:
STUDENT SERVICES BUILDING 4TH FLOOR, (SSB 4.600)
Provider Business Practice Location Address City Name:
RICHARDSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75080-3021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-883-2575
Provider Business Practice Location Address Fax Number:
972-883-6413
Provider Enumeration Date:
06/30/2014