| Doctor Name: | DR. JESUS R PORTELA |
| NPI Number: | 1194832220 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | F6303 |
| Business Practice Address: | 5818 Pebble Bank Lane Houston, TX - 770416847 |
| Business Phone Number: | 7139272494 |
| Business Fax Number: | 7139816468 |
| Mailing Address: | 5818 Pebble Bank Lane, HOUSTON |
| State: | TX |
| Postal Code: | 770416847 |
| Phone Number: | 7136972494 |
| Fax Number: | 7136957602 |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 01/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | F6303 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |