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General NPI Number Information
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NPI Number | 1760676902
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Entity Type | Organization
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Legal Business Name | R. WAYNE PORTER, M.D., P.A.
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 303 E COLLEGE ST STE A
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City | TERRELL
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State | TX
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Zip | 75160-2700
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Country | US
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Telephone | 972-563-6700
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Fax | 972-563-6656
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Provider Business Mailing Address
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Address Line | 303 E COLLEGE ST STE A
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City | TERRELL
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State | TX
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Zip | 75160-2700
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Country | US
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Telephone | 972-563-6700
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Fax | 972-563-6656
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. R. WAYNE PORTER
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Credential | M.D.
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Telephone | 972-563-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H2162
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License Number State | TX
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