Provider Demographics
NPI:1346429677
Name:PORTER, JOSEPHINE KATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:KATHERINE
Last Name:PORTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPHINE
Other - Middle Name:KATHERINE
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:523 S FANNIN AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8204
Mailing Address - Country:US
Mailing Address - Phone:903-535-9041
Mailing Address - Fax:
Practice Address - Street 1:928 N GLENWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-5055
Practice Address - Country:US
Practice Address - Phone:903-535-9041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00579207V00000X
TXP8366207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01291275OtherRAIL ROAD
TX334000201Medicaid
TX45-2578435-002OtherTRICARE
TX8EC309OtherBCBS
TX45-2578435-001OtherTRICARE
TX330694YR7VMedicare PIN