Most Relevant Information
Provider Data
| NPI Number: | 1003316522 |
| Provider Name: | BONNIE FAYE PORTER LVN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 155417 |
Most Important Dates
| Enumeration Date: | 02/21/2018 |
| Last Updated: | 02/21/2018 |
Provider Practice Location
12371 S KIRKWOOD RD
STAFFORD
TX
774772836
Practice Location Phone/Fax
| Phone: | 7139959292 |
| Fax: |
Provider Mailing Location
9310 SPELLMAN RD
HOUSTON
TX
770312227
Provider Mailing Phone/Fax
| Phone: | 8328893795 |
| Fax: |