Provider Demographics
NPI:1851595656
Name:PORTILLO, ARTURO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:
Last Name:PORTILLO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 BABCOCK RD # 213
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2134
Mailing Address - Country:US
Mailing Address - Phone:210-771-1703
Mailing Address - Fax:
Practice Address - Street 1:5804 BABCOCK RD # 213
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2134
Practice Address - Country:US
Practice Address - Phone:210-771-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244516282N00000X
TXN1073207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No282N00000XHospitalsGeneral Acute Care Hospital