Provider Demographics
NPI:1790980993
Name:PORTERFIELD, LAURA RENEE (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RENEE
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:RENEE
Other - Last Name:BYRNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-1385
Mailing Address - Country:US
Mailing Address - Phone:409-772-2166
Mailing Address - Fax:409-772-2663
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1385
Practice Address - Country:US
Practice Address - Phone:409-772-2166
Practice Address - Fax:409-772-2663
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS046790207Q00000X
TXP8067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine