Provider Demographics
NPI:1437187549
Name:WHITE, ROBERT ERICKSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERICKSON
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 S GESSNER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2005
Mailing Address - Country:US
Mailing Address - Phone:713-266-7673
Mailing Address - Fax:713-266-4744
Practice Address - Street 1:2405 S GESSNER RD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2005
Practice Address - Country:US
Practice Address - Phone:713-266-7673
Practice Address - Fax:713-266-4744
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXC8498207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD69253Medicare UPIN
TX8F3330Medicare PIN