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Jane Wofford Porter
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NPI Number Detailed Information
Provider Information:
| Name: | Jane Wofford Porter |
| Gender: | F |
| Provider License Number If Given: | 50248 |
NPI Information:
| NPI: | 1992708937 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 5/30/2008 |
Provider Business Mailing Address:
| Address: | 800 W AIRPORT FWY STE 118A Irving, TX 75062 |
| Phone Number: | 9724389360 |
| Fax Number: | 9725548767 |
Provider Business Practice Location Address:
| Address: | 800 W AIRPORT FWY STE 118A Irving, TX 75062 |
| Phone Number: | 9724389360 |
| Fax Number: | 9725548767 |
Provider Taxonomy:
| Primary: | 231H00000X |
| Secondary (if any): | |
| State: | TX |
