Mary Elizabeth Porisch, M.D.
Pediatrics, Pediatric Cardiology in San Antonio, TX. Individual provider (NPI-1).
NPI number1790741254
StatusActive
Last updated in NPPESSep 21, 2010
Details
- NPI
- 1790741254
- Entity type
- Individual (NPI-1)
- Name
- Mary Elizabeth Porisch
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 25, 2006
- Last updated
- Sep 21, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0202X | Pediatrics, Pediatric Cardiology | L0907 | TX | Yes |
Practice location
4499 Medical DrSuite 272
San Antonio, TX 78229-3735
Phone 210-614-3264 · Fax 210-615-0888
Mailing address
1510 BelclaireSan Antonio, TX 78258-4493
Phone 210-292-6635 · Fax 210-292-7902
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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