| Street | 2915 Glenwood Ave | ||
| City/Town | Wichita Falls | ||
| State/Province/Region | Texas | ||
| Zip/Postal Code | 76308 | ||
| Phone Number | (800) 326-3264 | ||
| Country | United States |
| Full Name | Dr. Lue Bahringer | ||
| Gender | female | ||
| Birthday | 1998-05-01 | ||
| Social Security Number | 490-29-1718 |
| Credit card brand | EnRoute | ||
| Credit card number | 2014373939871407 | ||
| Expire | 2031/10 | ||
| CVV | 325 |