Jose Angel Portillo Jr.

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

2121383 Issued in TX

Practice address

444 Executive Center Blvd Ste 148
El Paso, TX 79902-1096

Phone

(903) 251-2459

NPI assigned

Jan 4, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1649040122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 EXECUTIVE CENTER BLVD STE 148",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021096",
            "telephone_number": "903-251-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 EXECUTIVE CENTER BLVD STE 148",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021096",
            "telephone_number": "903-251-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "JOSE",
        "middle_name": "ANGEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "TX",
            "license": "2121383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica C Portillo, M.D.
• Celeste Marie Portillo
• Elahiny Mairam Portillo
• Elizabeth Portillo
• Gloria Portillo, LCDC
• Larissa C Portillo
• Ofelia Leyva Portillo, AGACNP-BC
• Ricardo Portillo, PHYSICAL THERAPIST
• Sarah Louise Portillo, DNP, FNP-C
• Elizabeth Ann Portugal, CNM

• Pediatric Rehabilitation Medicine Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatric Rehabilitation Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.