Individual
BETSY O. PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5201 HARRY HINES BLVD, MEDICAL STAFF SERVICES, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
232409
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138628601
—
TX
05
—
138628602
—
TX
05
—
138628603
—
TX
05
—
138628604
—
TX
05
—
138628605
—
TX
05
—
138628606
—
TX
05
—
138628607
—
TX
05
—
138628608
—
TX
05
—
138628610
—
TX
05
—
138628611
—
TX
05
—
138628612
—
TX
05
—
138628613
—
TX
01
—
8Y0748
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/05/2005
Last updated
07/25/2008
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