Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | Q9922 | TX |
Y | 208600000X | Surgeon | Q9922 | TX |
N | 2086S0102X | Surgical Critical Care | Q9922 | TX |
N | 2086S0127X | Trauma Surgeon | A136250 | CA |
N | 2086S0127X | Trauma Surgeon | Q9922 | TX |
NPI | 1467773978 |
---|---|
Provider Name | Dr. Terris Laurent White |
First Address | Wichita Falls, TX 76301-4300 |
Second Address | Wichita Falls, TX 76301-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 13/09/2019 |