Provider Demographics
NPI:1497791073
Name:PORRAS, CIRO JORGE (MD)
Entity Type:Individual
Prefix:
First Name:CIRO
Middle Name:JORGE
Last Name:PORRAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CIRO
Other - Middle Name:JORGE
Other - Last Name:PORRAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6510 HILLCROFT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081
Mailing Address - Country:US
Mailing Address - Phone:713-988-6677
Mailing Address - Fax:713-988-0123
Practice Address - Street 1:6510 HILLCROFT
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081
Practice Address - Country:US
Practice Address - Phone:713-988-6677
Practice Address - Fax:713-988-0123
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1182208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B25603Medicare UPIN