Individual
IRMA PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
16803 S LIGHTHOUSE DR, CROSBY, TX 77532-4532
(713) 299-8393
Mailing address
16803 S LIGHTHOUSE DR, CROSBY, TX 77532-4532
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
187916
TX
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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