Provider Demographics
NPI:1053862102
Name:OKC NEUROLOGY-CATHERINE E PORTER MD, PLLC
Entity Type:Organization
Organization Name:OKC NEUROLOGY-CATHERINE E PORTER MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-943-5677
Mailing Address - Street 1:5500 NW EXPRESSWAY STE E
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5218
Mailing Address - Country:US
Mailing Address - Phone:405-943-5677
Mailing Address - Fax:405-730-8124
Practice Address - Street 1:6701 W HEFNER RD STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4706
Practice Address - Country:US
Practice Address - Phone:405-943-5677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28957261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200694070AMedicaid