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Organization
LETICIA A PORET MD PA
Active
Organization
LETICIA A PORET MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LETICIA ANN PORET MD (PHYSICIAN)
(210) 733-3005
Entity
Organization
Contact information
Practice address
4522 FREDERICKSBURG RD, SUITE A 14, SAN ANTONIO, TX 78201-6521
(210) 733-3005
Mailing address
12627 STONEHENGE DR, SAN ANTONIO, TX 78230-1941
(210) 733-3005
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H9289
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009QF
BC BS
TX
01
—
00182U
MEDICARE
TX
Enumeration date
09/20/2006
Last updated
01/15/2008
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