Provider Demographics
NPI:1851884217
Name:WHITE, CRAIG DEWAYNE SR
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:DEWAYNE
Last Name:WHITE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10322 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-4218
Mailing Address - Country:US
Mailing Address - Phone:832-203-2584
Mailing Address - Fax:
Practice Address - Street 1:10322 SIERRA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-4218
Practice Address - Country:US
Practice Address - Phone:832-203-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)