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Individual

MICHAEL LAWRENCE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA, SA-C

Contact information

Practice address
2811 MANCHESTER LN, GRAPEVINE, TX 76051-4731
(214) 227-2457
(214) 764-0880
Mailing address
2811 MANCHESTER LN, GRAPEVINE, TX 76051-4731
(214) 227-2457
(214) 764-0880

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
4268
AZ
363AS0400X
Surgical Physician Assistant
Primary
PA06738
TX

Other

Enumeration date
09/22/2008
Last updated
03/04/2026
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