Individual
ELIZABETH PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6124 W PARKER RD STE 136, PLANO, TX 75093-8124
(972) 981-7711
Mailing address
7777 FOREST LN STE C234, DALLAS, TX 75230-6839
(972) 981-7711
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
T2720
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2017
Last updated
09/11/2024
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