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Organization
KRIS DANIEL PORTER, MD, PA
Active
Organization
KRIS DANIEL PORTER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRIS DANIEL PORTER M.D. (CEO)
(817) 441-6136
Entity
Organization
Contact information
Practice address
94 BLUFF VW, ALEDO, TX 76008-4580
(817) 441-6136
(817) 441-6145
Mailing address
94 BLUFF VW, ALEDO, TX 76008-4580
(817) 441-6136
(817) 441-6145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J8509
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J8509
MEDICAL LICENSE
TX
Enumeration date
09/16/2015
Last updated
09/16/2015
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