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NPI 1740583533

NPI 1740583533 : SCOTT A PORTER MD PA : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1740583533
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    Entity Type          |    Organization 
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    Legal Business Name  |    SCOTT A PORTER MD PA 
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Dates
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    Enumeration Date     |    12/16/2010
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    Last Update Date     |    07/29/2011
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Provider Practice Location Address
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    Address Line         |    7777 FOREST LN A310
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75230-2584
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    Country              |    US
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    Telephone            |    972-566-7777
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7777 FOREST LN A310
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75230-2584
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    Country              |    US
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    Telephone            |    972-566-7777
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. SCOTT A PORTER 
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    Credential           |    MD
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    Telephone            |    972-566-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    F9971
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    License Number State |    TX
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