MEDICARE: STEPHEN J WHITE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	N6768	TX

General Provider Information

NPI Number	:	1144226812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN J WHITE MD

Provider Business Mailing Address
First Line	:	4601 HERITAGE TRACE PARKWAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244
Country	:	US
Telephone Number	:	817-431-7985
Fax Number	:	817-431-5031

Provider Business Practice Location Address
First Line	:	4601 HERITAGE TRACE PARKWAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244
Country	:	US
Telephone Number	:	817-431-7985
Fax Number	:	817-431-5031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/16/2025

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