Boris Porto, M.D., P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

H4621 Issued in TX

Legal business name

BORIS PORTO, M.D., P.A.

Practice address

4412 74TH St
Suite E102
Lubbock, TX 79424-2328

Phone

(806) 792-7843

Fax

(806) 792-7675

NPI assigned

Jun 5, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Boris Porto, M.D.NPI 1912017922

Title

President

Phone

(806) 771-1386

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Boris Porto, M.D.

  • Psychiatry Physician
  • Lubbock, TX
  • NPI 1912017922
  Medicare reassignment NPD Authorized official
• Robert 'Harmon' Meixner, LPC

  • Mental Health Counselor
  • Lubbock, TX
  • NPI 1477629608
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1215196142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54136",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794534136",
            "telephone_number": "806-771-1386",
            "fax_number": "806-771-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 74TH ST",
            "address_2": "SUITE E102",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242328",
            "telephone_number": "806-792-7843",
            "fax_number": "806-792-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORIS PORTO, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "PORTO",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-771-1386",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H4621",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "H4621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199787601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0069RQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kandis Wright Boothe, MD, PHD
• William David Boothe, M.D.
• William David Boothe Jr., M.D.
• Frances Greg Y Bordon, ACNP
• Anne Renee Borges, LPC
• Seth Borne-Smith, MD
• Mounir Y Borno, M.D.
• Maria Stella Borromeo, LCDC
• Christina Nicole Borunda, SLP
• Krystal Borunda, RBT

• Psychiatry Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.