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NPI Code Detail

MEDICARE: LAURA PORTER PHARMD

MEDICARE: LAURA PORTER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist50409TX

General Provider Information

NPI Number : 1457631566
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA PORTER PHARMD
Provider Business Mailing Address
First Line : 4522 FREDERICKSBURG RD
Second Line : T-1523
City : BALCONES HEIGHTS
State : TX
Zip : 78201-6521
Country : US
Telephone Number : 210-280-0001
Fax Number :
Provider Business Practice Location Address
First Line : 4522 FREDERICKSBURG RD
Second Line : T-1523
City : BALCONES HEIGHTS
State : TX
Zip : 78201-6521
Country : US
Telephone Number : 210-280-0001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2011
Last Update Date : 08/19/2011

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Directions to “ LAURA PORTER PHARMD” Practice Location

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