Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 23, 2014
License(s)
BP10049438 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 11614 WINDY LN | Houston, TX 77024-6306 | 281-389-5577 |
| LOCATION | 6620 MAIN ST BCM 620 | Houston, TX 77030-2348 | 281-389-5577 |
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