Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | N4200 | TX |
N | 208200000X | Surgeon | N4200 | TX |
N | 208600000X | Surgeon | N4200 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | N4200 | TX |
NPI | 1255589180 |
---|---|
Provider Name | Dr. Aisha Dalila White |
First Address | Austin, TX 78730-1167 |
Second Address | Austin, TX 78730-1167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 25/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036116290 | (05) | IL |
3932056 | BCBS (01) | IL |
721089 | AETNA (01) | IL |