Individual
MARK ANTHONY PORRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
6028 SURETY DR., EL PASO, TX 79905
(915) 781-2901
Mailing address
528 MARTHA WAY, EL PASO, TX 79907
(915) 820-0838
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
403939
TX
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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