Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | E4920 | TX |
NPI | 1023147824 |
---|---|
Provider Name | Dr. Mitchell M. Porias |
First Address | Houston, TX 77025-1697 |
Second Address | Houston, TX 77008-1646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036023202 | (05) | TX |
A67517 | (02) | TX |