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General NPI Number Information
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NPI Number | 1952383838
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Entity Type | Individual
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Provider Name | VERNICKA DESHAWN PORTER-SALES D.O.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 17634 BEAR RIVER LN
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City | HUMBLE
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State | TX
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Zip | 77346-1558
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Country | US
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Telephone | 409-782-2434
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Fax |
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Provider Business Mailing Address
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Address Line | 11097B NORTHWEST FREEWAY
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City | HOUSTON
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State | TX
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Zip | 77092
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Country | US
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Telephone | 713-496-1331
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Fax | 713-496-1334
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L4650
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | L4650
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License Number State | TX
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