Provider Demographics
NPI:1912319161
Name:CESAR H PORTA MD PLLC
Entity Type:Organization
Organization Name:CESAR H PORTA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-763-1200
Mailing Address - Street 1:706 DENVER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4140
Mailing Address - Country:US
Mailing Address - Phone:940-763-1200
Mailing Address - Fax:940-763-1207
Practice Address - Street 1:1600 11TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4300
Practice Address - Country:US
Practice Address - Phone:940-763-1200
Practice Address - Fax:940-763-1207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center