Provider Demographics
NPI:1992708937
Name:PORTER, JANE WOFFORD (AUD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:WOFFORD
Last Name:PORTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W AIRPORT FWY
Mailing Address - Street 2:STE 118A
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6313
Mailing Address - Country:US
Mailing Address - Phone:972-438-9360
Mailing Address - Fax:972-554-8767
Practice Address - Street 1:800 W AIRPORT FWY
Practice Address - Street 2:STE 118A
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6313
Practice Address - Country:US
Practice Address - Phone:972-438-9360
Practice Address - Fax:972-554-8767
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50248231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist