Individual
DANIEL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
605 S CONROE MEDICAL DR, CONROE, TX 77304-4722
(936) 539-4004
(936) 539-3635
Mailing address
605 S CONROE MEDICAL DR, CONROE, TX 77304-4722
(936) 539-4004
(936) 539-3635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N1072
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204338201
—
TX
01
—
8282049
CIGNA
—
01
—
8U6206
BLUE CROSS BLUE SHIELD
—
01
—
9049383
AETNA
—
Enumeration date
05/10/2007
Last updated
03/07/2023
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