Registry details
Type
Individual
Primary specialty
Internal Medicine, Cardiovascular Disease
Enumerated
Jun 20, 2005
License(s)
K2392 (TX), K2392 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 951406 | Dallas, TX 75395-1406 | 409-963-0000 |
| LOCATION | 3921 N TWIN CITY HWY | Port Arthur, TX 77642-2118 | 409-963-0000 |
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