Provider Demographics
NPI:1063498962
Name:WHITE, PHILIP ANDREW III (LSA CSA)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ANDREW
Last Name:WHITE
Suffix:III
Gender:M
Credentials:LSA CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 PLAZAS DEL LAGO DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-7700
Mailing Address - Country:US
Mailing Address - Phone:956-380-3330
Mailing Address - Fax:
Practice Address - Street 1:3507 PLAZAS DEL LAGO DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7700
Practice Address - Country:US
Practice Address - Phone:956-380-3330
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00155246XC2901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularCardiovascular Invasive Specialist