Provider Demographics
NPI:1114030343
Name:PORTUGAL, DAVID ALEXANDER (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALEXANDER
Last Name:PORTUGAL
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Gender:M
Credentials:MD, FACC
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Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:713-338-5500
Practice Address - Street 1:7737 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 780
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-988-9512
Practice Address - Fax:713-988-9515
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2012-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ5626207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060053361OtherRAILROAD MEDICARE
TX043241101Medicaid
TXG11084Medicare UPIN
TX043241101Medicaid