Porter, Clarence Milton

Porter, Clarence Milton is an individual health care provider with primary practice located at 14100 Nacogdoches Rd Ste 116, San Antonio TX 78247-1903. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Porter, Clarence Milton can be contacted via phone (210) 653-8989.

Contact Information

Primary practice address
14100 Nacogdoches Rd Ste 116 San Antonio TX 78247-1903
Fax: (210) 590-4608
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X F3292 Texas

Profile Details

NPI number 1407853104
LBN Legal business name Porter, Clarence Milton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Oct 18th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407853104 NPPES
Texas Other 0994741-03 WELLMED MEDICAID
Texas Other 84V623 WELLMED MEDICAID

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