Joe Bob Porter D.O.

NPI 1013096841 - Family Medicine - 207Q00000X

NPI Details
NPI 1013096841
Gender Male
Enumeration Date 11/03/2006
Last Updated 07/19/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
109 S BROADWAY
AZLE TX, 76020-3709, US
Phone (817) 366-7150
Fax (817) 444-7000
Business Location
109 S BROADWAY
AZLE TX, 76020-3709, US
Phone (817) 366-7150
Fax (817) 444-7000
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number F3293
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According to our database, Dr. Joe Bob Porter D.O. NPI is 1013096841, taxonomy code is 207Q00000X and license number is F3293, license state is located at Texas. Joe Bob Porter D.O. physically located at 109 S Broadway, Azle TX, 76020-3709. NPI Number Joe Bob Porter D.O. has the Individual type.

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1013096841 NPI number is provided on an as is basis without warranty of any kind. 1013096841 is maintained by the National Plan & Provider Enumeration System. The contents of Joe Bob Porter D.O. are for informational purposes only.