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NPI Code Detail

MEDICARE: DR. THOMAS W. PORTER III M.D.

MEDICARE: DR. THOMAS W. PORTER III 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
1207P00000XEmergency Medicine PhysicianJ2743TX
2207R00000XInternal Medicine PhysicianJ2743TX
3208000000XPediatrics PhysicianJ2742TX

General Provider Information

NPI Number : 1235230574
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS W. PORTER III M.D.
Provider Business Mailing Address
First Line : 7830 MOONLIGHT CT
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459
Country : US
Telephone Number : 281-431-3488
Fax Number : 281-431-4460
Provider Business Practice Location Address
First Line : 927 SHAW AVE
Second Line :
City : PASADENA
State : TX
Zip : 77506-1430
Country : US
Telephone Number : 713-982-5900
Fax Number : 281-431-9181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 02/28/2011

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