Individual
TIMOTHY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
519 N SAM HOUSTON PKWY E, HOUSTON, TX 77060-4051
(832) 943-4035
Mailing address
519 N SAM HOUSTON PKWY E, HOUSTON, TX 77060-4051
(832) 943-4035
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373188702
—
TX
Enumeration date
08/12/2019
Last updated
08/12/2019
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