Provider Demographics
NPI:1578540712
Name:MITCHELL M PORIAS DO PA
Entity Type:Organization
Organization Name:MITCHELL M PORIAS DO PA
Other - Org Name:NORTH LOOP EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:PORIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-681-6364
Mailing Address - Street 1:2030 N LOOP W
Mailing Address - Street 2:#200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018
Mailing Address - Country:US
Mailing Address - Phone:713-681-5367
Mailing Address - Fax:713-681-8202
Practice Address - Street 1:2030 N LOOP W
Practice Address - Street 2:#200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:713-681-5367
Practice Address - Fax:713-681-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4920207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4975890001OtherPALMETTO
4975890001OtherPALMETTO
TX00T537Medicare PIN