Provider Demographics
NPI:1801846753
Name:SIMPSON-WHITE, ELCENIA (MD)
Entity Type:Individual
Prefix:
First Name:ELCENIA
Middle Name:
Last Name:SIMPSON-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 1:3601 MACGREGOR DR NORTH
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:713-873-4708
Mailing Address - Fax:713-873-4729
Practice Address - Street 1:3601 MACGREGOR NORTH
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004
Practice Address - Country:US
Practice Address - Phone:713-873-4708
Practice Address - Fax:713-873-4729
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9023207QA0505X, 207Q00000X
TXF42585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137693111Medicaid
TX8L14350Medicare PIN
TXS1082W183Medicare PIN
TXF42585Medicare UPIN