Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | D6207 | TX |
NPI | 1033141684 |
---|---|
Provider Name | Mr. Frederick A White |
First Address | Abilene, TX 79601-2435 |
Second Address | Abilene, TX 79601-2435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 17/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0914418-04 | (05) | TX |
C23420 | (02) | TX |