Healthcare Provider Details

I. General information

NPI: 1053862102
Provider Name (Legal Business Name): OKC NEUROLOGY-CATHERINE E PORTER MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 NW EXPRESSWAY STE E
WARR ACRES OK
73132-5218
US

IV. Provider business mailing address

5500 NW EXPRESSWAY STE E
WARR ACRES OK
73132-5218
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-5677
  • Fax: 405-730-8124
Mailing address:
  • Phone: 405-943-5677
  • Fax: 405-730-8124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number28957
License Number StateOK

VIII. Authorized Official

Name: DR. CATHERINE E PORTER
Title or Position: PRESIDENT / OWNER
Credential: M.D.
Phone: 405-943-5677