Individual
CARLOS PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9091 FAIR OAKS PKWY STE 301, FAIR OAKS RANCH, TX 78015-4690
(210) 903-2002
Mailing address
5825 CALLAGHAN RD STE 203, SAN ANTONIO, TX 78228-1107
(210) 341-9614
(210) 340-5924
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J6667
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121373801
—
TX
05
—
121373802
—
TX
05
—
121373803
—
TX
05
—
121373804
—
TX
Enumeration date
08/10/2005
Last updated
04/30/2024
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