Provider Demographics
NPI:1225359219
Name:ENRIQUE PORRAS M.D.,P.A.
Entity Type:Organization
Organization Name:ENRIQUE PORRAS M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-598-2100
Mailing Address - Street 1:10470 VISTA DEL SOL DR STE 108
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7928
Mailing Address - Country:US
Mailing Address - Phone:915-598-2100
Mailing Address - Fax:915-598-2102
Practice Address - Street 1:10470 VISTA DEL SOL DR STE 108
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7928
Practice Address - Country:US
Practice Address - Phone:915-598-2100
Practice Address - Fax:915-598-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8346207R00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty