Individual
HOLLY PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
894 US HIGHWAY 77, ROSEBUD, TX 76570
(254) 721-2563
(254) 583-7829
Mailing address
894 US HIGHWAY 77, ROSEBUD, TX 76570-3325
(254) 721-2563
(254) 583-7829
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP126462
TX
Other
Enumeration date
09/19/2014
Last updated
01/17/2019
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