Healthcare Provider Details

I. General information

NPI: 1699685255
Provider Name (Legal Business Name): CORA PHYSICIAN GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28750 TOMBALL PKWY
TOMBALL TX
77375
US

IV. Provider business mailing address

28750 TOMBALL PKWY
TOMBALL TX
77375
US

V. Phone/Fax

Practice location:
  • Phone: 713-955-2665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JASMINE PORTERIE
Title or Position: BILLING MANAGER
Credential:
Phone: 713-955-2665