Provider Demographics
NPI:1760130405
Name:WHITE, AMY DANIELLE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DANIELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10526 FAIRLAND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-4250
Mailing Address - Country:US
Mailing Address - Phone:346-243-0321
Mailing Address - Fax:
Practice Address - Street 1:10526 FAIRLAND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-4250
Practice Address - Country:US
Practice Address - Phone:346-243-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care