Provider Demographics
NPI:1053447607
Name:PORTER, DONALD COLUMBUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:COLUMBUS
Last Name:PORTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 450152
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77245
Mailing Address - Country:US
Mailing Address - Phone:713-433-7662
Mailing Address - Fax:713-433-8930
Practice Address - Street 1:13324 ONE HALF ALMEDA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045
Practice Address - Country:US
Practice Address - Phone:713-433-7662
Practice Address - Fax:713-433-8930
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12690122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist