Stephanie Portillo, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1058111 Issued in TX

Practice address

4949 Fairmont Pkwy Ste 200
Pasadena, TX 77505-3757

Phone

(713) 941-1177

NPI assigned

Jan 6, 2022

Last updated

Oct 7, 2023By the provider in NPPES

Sex

Female

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sportillo146365@prddirect.texaschildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids Care Pediatrics, PA.

  • Pediatrics Physician
  • Houston, TX
  • NPI 1972810083
  NPD (past)
• TCH Pediatric Associates, Inc

  dba Texas Children's Pediatric Associates

  • Pediatrics Physician
  • Houston, TX
  • NPI 1225038326
  NPD (past)
• TCH Pediatric Associates, Inc

  dba TCP Grand Parkway

  • Pediatrics Physician
  • Sugar Land, TX
  • NPI 1861492654
  NPD (past)

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1790446227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 FAIRMONT PKWY STE 200",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 FAIRMONT PKWY STE 200",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053757",
            "telephone_number": "713-941-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "STEPHANIE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1058111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Joseph Ponce III, MD
• Laura Elisabeth Poppe, APRN, PNP-PC
• Victoria H Poppelaars, PA
• Portal Dental Pasadena PLLC
• Thomas W. Porter III, M.D.
• David A Potts, DC
• Maria Power
• Lyndsey Lafitte Prather, MD
• Premier Health Care Group PLLC
• Premier Heart Specialists P a (Palur V Balakrishnan MD)

• Pediatric Nurse Practitioner in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; 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.