Individual
DR. CHARLES THOMAS PORTER JR.
Active
Individual
DR. CHARLES THOMAS PORTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H5606
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050088140
RAILROAD MEDICARE
TX
01
—
125444306
SUPERIOR HEALTH CHIPS
TX
05
—
125444306
—
TX
01
—
8616B6
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/12/2005
Last updated
01/28/2008
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