Registry details
Type
Individual
Primary specialty
—
Enumerated
Oct 18, 2016
License(s)
U5056 (TX), U5056 (TX), U5056 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4502 MEDICAL DR | San Antonio, TX 78229-4402 | 210-358-4000 |
| LOCATION | 4502 MEDICAL DR | San Antonio, TX 78229-4402 | 210-358-4000 |
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