Provider Demographics
NPI:1205637899
Name:PORTER HILL, LASHAWN
Entity type:Individual
Prefix:
First Name:LASHAWN
Middle Name:
Last Name:PORTER HILL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BOWIE ST
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-9051
Mailing Address - Country:US
Mailing Address - Phone:469-877-7396
Mailing Address - Fax:
Practice Address - Street 1:4314 MALCOLM X BLVD STE B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-4307
Practice Address - Country:US
Practice Address - Phone:214-771-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier