Individual
STEPHANIE PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
4949 FAIRMONT PKWY STE 200, PASADENA, TX 77505-3757
(713) 941-1177
Mailing address
4949 FAIRMONT PKWY STE 200, PASADENA, TX 77505-3757
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1058111
TX
Other
Enumeration date
01/06/2022
Last updated
10/07/2023
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