Individual
EARNEST A PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6324 GLENWICK DR, FORT WORTH, TX 76123-1565
(682) 472-6112
Mailing address
6324 GLENWICK DR, FORT WORTH, TX 76123-1565
(682) 472-6112
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
11471689
TX
Other
Enumeration date
06/07/2020
Last updated
06/07/2020
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