Provider Demographics
NPI:1578889572
Name:PORTER, ANGEL M (RN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:M
Last Name:PORTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9191 PINECROFT DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2796
Mailing Address - Country:US
Mailing Address - Phone:281-681-3905
Mailing Address - Fax:281-362-0403
Practice Address - Street 1:9191 PINECROFT DR
Practice Address - Street 2:SUITE 150
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2796
Practice Address - Country:US
Practice Address - Phone:281-681-3905
Practice Address - Fax:281-362-0403
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX716735163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant