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Individual

DR. HOMA JACKSON PORTER II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8230 WALNUT HILL LN, SUITE 700, DALLAS, TX 75231-4482
(214) 691-1902
(214) 987-1845
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L8894
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
168549701
TX
05
168549702
TX
01
8M6732
BCBS PROVIDER ID
01
P00129571
RRMCR
TX
Enumeration date
05/27/2006
Last updated
01/31/2017
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