Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 1, 2005
License(s)
H0124 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 12554 RIATA VISTA CIR | Austin, TX 78727-6431 | 512-795-5100 |
| MAILING | 12554 RIATA VISTA CIR | Austin, TX 78727-6431 | 512-795-5100 |
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