Provider Demographics
NPI:1841291028
Name:PORTER-TUCCI, LINDA C (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:PORTER-TUCCI
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 1:3701 KIRBY DR STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3926
Mailing Address - Country:US
Mailing Address - Phone:713-798-4491
Mailing Address - Fax:
Practice Address - Street 1:3743 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5439
Practice Address - Country:US
Practice Address - Phone:713-798-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FT471OtherBLUE CROSS BLUE SHIELD
TX8EB313OtherBLUE CROSS BLUE SHIELD
TX149927901Medicaid
TX149927901Medicaid
TX324465ZSWCMedicare PIN
TX324465YUD8Medicare PIN