1013194679 NPI number — DAVID A WHITING MD PA

Table of content: (NPI 1013194679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013194679 NPI number — DAVID A WHITING MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID A WHITING MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013194679
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 GASTON AVE STE 1058
Provider Second Line Business Mailing Address:
WADLEY TOWER
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75246-1910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-820-4247
Provider Business Mailing Address Fax Number:
214-824-0012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 GASTON AVE STE 1058
Provider Second Line Business Practice Location Address:
WADLEY TOWER
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75246-1910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-820-4247
Provider Business Practice Location Address Fax Number:
214-824-0012
Provider Enumeration Date:
01/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARLIN
Authorized Official First Name:
DEBBIE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
214-820-4247

Provider Taxonomy Codes

  • Taxonomy code: 207ND0900X , with the licence number:  F2110 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0102X , with the licence number: F2110 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)