# STEPHANIE A PORTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063492163
- **Authorized official:** DR. STEPHANIE ANN PORTER M.D. (PEDIATRICIAN)
- **Authorized official phone:** (940) 676-6777

## Contact information

- **Practice address:** 149 HART ST, SHEPPARD AFB, TX 76311-3477
- **Practice address phone:** (940) 676-6777
- **Practice address fax:** (940) 676-2706
- **Mailing address:** 149 HART ST, SHEPPARD AFB, TX 76311-3477
- **Mailing address phone:** (940) 642-6231
- **Mailing address fax:** (940) 676-2706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | L3841 | TX | Yes |

## Other

- **Enumeration date:** 01/17/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 60135092 | DPS - TX | TX |