Active NPI
Joe Bob Porter, D.O.
- Family Medicine Physician
- Azle, TX
National Provider Identifier
1013096841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- F3293
- Practice address
- 109 S Broadway
Azle, TX 76020-3709 - Phone
- (817) 366-7150
- Fax
- (817) 444-7000
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | F3293 | TX | Primary |
Addresses
Primary practice location
109 S Broadway
Azle, TX 76020-3709
Mailing address
109 S Broadway
Azle, TX 76020-3709
Phone (817) 366-7150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3293 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1013096841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 S BROADWAY",
"city": "AZLE",
"state": "TX",
"postal_code": "760203709",
"telephone_number": "817-366-7150",
"fax_number": "817-444-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 S BROADWAY",
"city": "AZLE",
"state": "TX",
"postal_code": "760203709",
"telephone_number": "817-366-7150",
"fax_number": "817-444-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JOE",
"middle_name": "BOB",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "F3293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.