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Individual

LESLIE DEAN PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
909 N WASHINGTON AVE, DALLAS, TX 75246-1520
(214) 820-9637
(214) 820-9339
Mailing address
909 N WASHINGTON AVE, DALLAS, TX 75246-1520
(214) 820-9637
(214) 820-9339

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G5494
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132548203
TX
05
132548207
TX
01
8BR151
BCBS
TX
Enumeration date
08/05/2006
Last updated
10/14/2022
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