Provider Demographics
NPI:1780440149
Name:WHITE, DAVID HAROLD JR
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HAROLD
Last Name:WHITE
Suffix:JR
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 1:3174 SUNSET CV
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6836
Mailing Address - Country:US
Mailing Address - Phone:317-529-3395
Mailing Address - Fax:
Practice Address - Street 1:3174 SUNSET CV
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6836
Practice Address - Country:US
Practice Address - Phone:317-529-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health