Provider First Line Business Practice Location Address:
2002 HOLCOMBE BLVD
Provider Second Line Business Practice Location Address:
RCL(117) - MICHAEL E DEBAKEY VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-794-7117
Provider Business Practice Location Address Fax Number:
713-794-7631
Provider Enumeration Date:
07/20/2006