| Boris Porto, M.d., P.a. | |
|
4412 74th St Suite E102 Lubbock TX 79424-2328 | |
| (806) 792-7843 | |
| (806) 792-7675 |
| Full Name | Boris Porto, M.d., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4412 74th St, Lubbock, Texas |
| Authorized Official Name and Position | Boris Porto (PRESIDENT) |
| Authorized Official Contact | 8067711386 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boris Porto, M.d., P.a. Po Box 54136 Lubbock TX 79453-4136 Ph: (806) 771-1386 | Boris Porto, M.d., P.a. 4412 74th St Suite E102 Lubbock TX 79424-2328 Ph: (806) 792-7843 |
| NPI Number | 1215196142 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 06/05/2009 |
| Medicare PECOS PAC ID | 0446322424 |
|---|---|
| Medicare Enrollment ID | O20080708000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215196142 | NPI | - | NPPES |
| 199787601 | Medicaid | TX | |
| 0069RQ | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | H4621 (Texas) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | H4621 (Texas) | Secondary |
| Provider Name | Boris Joseph Porto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912017922 PECOS PAC ID: 1456423433 Enrollment ID: I20080708000570 |
Gabrielle K Keenum Ma Lpc Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6309 Indiana Ave Ste D, Lubbock, TX 79413 Phone: 806-790-1327 Fax: 806-863-3874 | |
Lubbock Accident & Injury Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5201 Indiana Ave, Lubbock, TX 79413 Phone: 806-793-7246 | |
Desert Sky Family Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5504 Wayne Ave Ste 109, Lubbock, TX 79414 Phone: 806-853-7292 | |
Denovo Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 50th St Ste 501, Lubbock, TX 79412 Phone: 806-370-3157 Fax: 806-243-4002 | |
G. Gary Walker, Ph.d., P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5120 29th Dr Ste D, Lubbock, TX 79407 Phone: 806-798-8855 Fax: 806-792-5715 | |
Swmh Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4413 71st St Ste G101, Lubbock, TX 79424 Phone: 806-438-8089 | |
John Cobb, M.d., Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6502 Slide Road, Suite 311, Lubbock, TX 79424 Phone: 806-771-1386 Fax: 806-771-1388 |