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NPI Code Detail

MEDICARE: CARLOS PORTER M.D.

MEDICARE:   CARLOS  PORTER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianJ6667TX

Other Identifiers

General Provider Information

NPI Number : 1013918242
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS PORTER M.D.
Provider Business Mailing Address
First Line : 5825 CALLAGHAN RD STE 203
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-1107
Country : US
Telephone Number : 210-341-9614
Fax Number : 210-340-5924
Provider Business Practice Location Address
First Line : 9091 FAIR OAKS PKWY STE 301
Second Line :
City : FAIR OAKS RANCH
State : TX
Zip : 78015-4690
Country : US
Telephone Number : 210-903-2002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 04/30/2024

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Directions to “ CARLOS PORTER M.D.” Practice Location

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