Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | H4791 | TX |
NPI | 1013961481 |
---|---|
Provider Name | Marlon D White |
First Address | Houston, TX 77070-4301 |
Second Address | Houston, TX 77070-4301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 02/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046028901 | (05) | TX |
E89162 | (02) | TX |