MEDICARE: PHILIP HAYDEN WHITE M.D.

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	207W00000X	Ophthalmology Physician	F2990	TX

General Provider Information

NPI Number	:	1558348474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP HAYDEN WHITE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1518
Second Line	:
City	:	JOSHUA
State	:	TX
Zip	:	76058-1518
Country	:	US
Telephone Number	:	903-243-4185
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 S LANCASTER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	800-849-3597
Fax Number	:	903-885-4916

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

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	04/12/2026

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