Provider Demographics
NPI:1649406752
Name:WHITE, GREGORY RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:RYAN
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5002 COWHORN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-9766
Mailing Address - Country:US
Mailing Address - Phone:903-614-3000
Mailing Address - Fax:903-614-3525
Practice Address - Street 1:5730 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1635
Practice Address - Country:US
Practice Address - Phone:430-200-5864
Practice Address - Fax:903-306-2624
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2024-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10034944-539667207R00000X
TXP1247207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine