Provider Demographics
NPI:1699725218
Name:PORTER, DEAN PRIEST (MD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:PRIEST
Last Name:PORTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 BEECHNUT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3106
Mailing Address - Country:US
Mailing Address - Phone:713-777-7145
Mailing Address - Fax:713-337-4803
Practice Address - Street 1:7710 BEECHNUT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3106
Practice Address - Country:US
Practice Address - Phone:713-777-7145
Practice Address - Fax:713-337-4803
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH8953207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136000006Medicaid
TX86X116Medicare PIN
TX136000006Medicaid