Provider Demographics
NPI:1629035910
Name:SEJOUR-WHITE, JEANNETTE NORMA (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:NORMA
Last Name:SEJOUR-WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W PLEASANT RUN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1079
Mailing Address - Country:US
Mailing Address - Phone:972-274-9100
Mailing Address - Fax:972-274-9101
Practice Address - Street 1:2700 W PLEASANT RUN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1079
Practice Address - Country:US
Practice Address - Phone:972-274-9100
Practice Address - Fax:972-274-9101
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8977208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH37534Medicare UPIN