Provider Demographics
NPI:1265734040
Name:WHITE, ALBERT E
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:E
Last Name:WHITE
Suffix:
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 1:3912 WELTER AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-5076
Mailing Address - Country:US
Mailing Address - Phone:702-204-0388
Mailing Address - Fax:888-503-3262
Practice Address - Street 1:3912 WELTER AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-5076
Practice Address - Country:US
Practice Address - Phone:702-204-0388
Practice Address - Fax:702-457-8000
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner