Individual
MICHEAL DEAN PORTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
810 W HIGHWAY 71, MARBLE FALLS, TX 78654-8602
(830) 201-8000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
601843
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP112725
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167386502
—
TX
01
—
86431U
BCBSTX
TX
Enumeration date
08/24/2005
Last updated
06/23/2023
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