JESSICA PORTILLO (NPI# 1316489370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316489370 |
| Entity Type | Individual |
| Full Name | JESSICA PORTILLO |
| Practice Address |
12611 Brookvale Dr Houston TX 77038-2006 |
| Mailing Address |
Po Box 940003 Houston TX 77094-7003 |
| Practice Telephone | 8323295680 |
| Mailing Telephone | 8323295680 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639581630 | Jessica Portillo | Family Medicine | 3020 14th St Nw, Washington, DC 20009-6865 | 2014-05-24 |
| Street Address |
12611 BROOKVALE DR |
| City | HOUSTON |
| State | TX |
| Zip Code | 77038-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871869545 | My West Mount Houston Dentist Inc | Dentist | 1500 West Mount Houston Road, Houston, TX 77038 | 2012-03-28 |
| 1699820266 | Danh Quang Le | Chiropractor | 10625 Veterans Memorial Dr., Suite E, Houston, TX 77038 | 2007-01-24 |
| 1043319569 | Jimmy N Crawford | Dentist | 1500 West Mount Houston Rd, Houston, TX 77038 | 2006-09-21 |
| 1275636896 | Danh Q Le | Chiropractor | 10625 Veterans Memorial Dr, Suite E, Houston, TX 77038 | 2006-09-07 |
| 1457406639 | Advanced Spinal Treatment Center | Chiropractor | 10625 Veterans Memorial Dr, Ste E, Houston, TX 77038 | 2007-01-25 |
| 1205302080 | Ursula Knowles | Occupational Therapy Assistant | 2503 Nelwood Dr, Houston, TX 77038-1021 | 2018-10-18 |
| 1588913305 | Jade Truong | Nurse Practitioner | 10625 Veterans Memorial Dr Ste D, Houston, TX 77038-1047 | 2012-09-07 |
| 1386090280 | Phuong Pham | Nurse Practitioner | 10411 Veterans Memorial Dr, Suite A, Houston, TX 77038-1047 | 2016-05-10 |
| 1104227867 | Lorena Jimenez | Nurse Practitioner | 10625 Veterans Memorial Dr Ste D, Houston, TX 77038-1047 | 2014-09-11 |
| 1336484468 | Ann Vo | Nurse Practitioner | 10625 Veterans Memorial Dr Ste D, Houston, TX 77038-1047 | 2012-11-29 |
| Find all providers in zip 77038 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309209 | Big Daddy Medical Supply | Durable Medical Equipment & Medical Supplies | 14747 Charlmont Dr, Houston, TX 77083-5645 | 2020-09-02 |
| 1083225528 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 110 E. Richey Rd, Houston, TX 77090-5802 | 2020-08-10 |
| 1689283145 | Iv & Home Health Services of Texas | Durable Medical Equipment & Medical Supplies | 7545 Cherry Park Dr, Houston, TX 77095-2722 | 2020-07-30 |
| 1982213542 | Apg Ancillaries LLC | Durable Medical Equipment & Medical Supplies | 14811 Saint Marys Ln Ste 152, Houston, TX 77079 | 2020-07-29 |
| 1609485697 | Houston Care Medical Supplies | Durable Medical Equipment & Medical Supplies | 440 Benmar Dr Ste 1022e, Houston, TX 77060-3271 | 2020-07-27 |
| 1750999306 | King Ross Medical Supply | Durable Medical Equipment & Medical Supplies | 5200 Mitchelldale St Ste F21, Houston, TX 77092-7221 | 2020-07-20 |
| 1346866738 | Tek Med 1 LLC | Durable Medical Equipment & Medical Supplies | 9009 North Loop E Ste 160a, Houston, TX 77029-1299 | 2020-06-22 |
| 1225654619 | Tek Med II, LLC | Durable Medical Equipment & Medical Supplies | 9009 North Loop E Ste 160b, Houston, TX 77029-1299 | 2020-06-22 |
| 1215553615 | Tek Med IIi, LLC | Durable Medical Equipment & Medical Supplies | 9009 North Loop E Ste 160c, Houston, TX 77029-1299 | 2020-06-22 |
| 1033732524 | Nextstage Medical, LLC | Durable Medical Equipment & Medical Supplies | 510 Bering Dr Ste 650, Houston, TX 77057-1451 | 2020-05-19 |
| Find all providers in HOUSTON | ||||
Please comment or provide details below to improve the information on JESSICA PORTILLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.