Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Aug 27, 2012
License(s)
29392570 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2916 EMERALD BROOK LANE | Pearland, TX 77584 | |
| LOCATION | 6431 FANNIN ST # 2.130B | Houston, TX 77030-1501 | 713-500-7583 |
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