Organization
MODERN PEDIATRICS PROFESSIONALS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY JAMES PORTER MD (CHIEF MEDICAL OFFICER)
(319) 541-7604
Entity
Organization
Contact information
Practice address
2309 SANTA MARIA ST, AUSTIN, TX 78702-4617
(319) 541-7604
Mailing address
2309 SANTA MARIA ST, AUSTIN, TX 78702-4617
(319) 541-7604
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up