Provider Demographics
NPI:1326188194
Name:PORRES, FELIPE G (MD)
Entity type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:G
Last Name:PORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 1189
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-1189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3980 STATE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8823
Practice Address - Country:US
Practice Address - Phone:940-891-0342
Practice Address - Fax:940-591-3207
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD198923207RN0300X, 207RN0300X
VA48950207RN0300X
OK22661207RN0300X
ARE2300207RN0300X
TXJ5670207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX30090843OtherSTATE CONTROLLED SUBSTANC
TX1256109-02Medicaid
TX30090843OtherSTATE CONTROLLED SUBSTANC
G03455Medicare UPIN