1912140138 NPI number — DR. STANFORD KERRY WHITE MD

Table of content: LUIS FELIPE SARAVIA CORTES (NPI 1861943094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912140138 NPI number — DR. STANFORD KERRY WHITE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
STANFORD
Provider Middle Name:
KERRY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITE
Provider Other First Name:
STANFORD
Provider Other Middle Name:
KERRY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1912140138
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 MAIN ST
Provider Second Line Business Mailing Address:
SUITE 5200
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75201-4612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-712-2430
Provider Business Mailing Address Fax Number:
214-712-2444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 FOUCHER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70115-3515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-897-7011
Provider Business Practice Location Address Fax Number:
214-712-2444
Provider Enumeration Date:
04/17/2009

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: MD.202910 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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