Organization
ENRIQUETA PORRAS M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUETA PORRAS M.D. (PRESIDENT/PHYSICIAN)
(602) 234-9611
Entity
Organization
Contact information
Practice address
600 W THOMAS RD, PHOENIX, AZ 85013-4213
(602) 234-9611
(602) 234-0011
Mailing address
600 W THOMAS RD, PHOENIX, AZ 85013-4213
(602) 234-9611
(602) 234-0011
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32731
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
941030
—
AZ
Enumeration date
09/02/2011
Last updated
09/02/2011
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