Individual
CASEY ANNE PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A. - C
Contact information
Practice address
1935 MEDICAL DISTRICT DR, PAVILLION 3RD FLOOR, DALLAS, TX 75235-7701
(214) 456-1798
Mailing address
8201 MEMORIAL LN, #2022, PLANO, TX 75024-2253
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03803
TX
Other
Enumeration date
04/26/2010
Last updated
04/08/2022
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