Provider First Line Business Practice Location Address:
3400 RAWLEY E CHAMBERS AVE
Provider Second Line Business Practice Location Address:
ISR CLINICAL DIV ISR ANESTHESIA BAMC 4RTH FLR
Provider Business Practice Location Address City Name:
FORT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-569-9782
Provider Business Practice Location Address Fax Number:
210-354-7174
Provider Enumeration Date:
03/15/2006