Provider Demographics
NPI:1760059786
Name:PLATERO PORTILLO, TANIA MARCELA (MD)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:MARCELA
Last Name:PLATERO PORTILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BAYLOR PLAZA
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-5928
Mailing Address - Fax:713-798-5838
Practice Address - Street 1:ONE BAYLOR PLAZA
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-5928
Practice Address - Fax:713-798-5838
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program