1427115195 NPI number — DR. JEFFREY WHEELER WHITE LMFT-S

Table of content: DR. JEFFREY WHEELER WHITE LMFT-S (NPI 1427115195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427115195 NPI number — DR. JEFFREY WHEELER WHITE LMFT-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
JEFFREY
Provider Middle Name:
WHEELER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
LMFT-S
Provider Gender Code:
M

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:
1427115195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7111 LA VISTA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75214-4225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-406-7376
Provider Business Mailing Address Fax Number:
214-224-2696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4124 OAK LAWN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75219-3136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-224-2693
Provider Business Practice Location Address Fax Number:
214-224-2696
Provider Enumeration Date:
01/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  000043 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 201322 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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