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NPI Code Detail

MEDICARE: XIMENA DENISSE PORTILLO

MEDICARE: XIMENA DENISSE PORTILLO
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
12355S0801XSpeech-Language Assistant

General Provider Information

NPI Number : 1861340390
Entity Type Code : Individual
Provider Name (Legal Business Name) : XIMENA DENISSE PORTILLO
Provider Business Mailing Address
First Line : 8418 HERA
Second Line :
City : UNIVERSAL CITY
State : TX
Zip : 78148-2763
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6585
Country : US
Telephone Number : 210-457-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2026
Last Update Date : 03/19/2026

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Directions to “ XIMENA DENISSE PORTILLO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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