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NPI Code Detail

MEDICARE: SHAUNA WHITE ATC

MEDICARE:   SHAUNA  WHITE  ATC
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
12255A2300XAthletic Trainer010802114OH

General Provider Information

NPI Number : 1578185880
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUNA WHITE ATC
Provider Business Mailing Address
First Line : 11433 E SAM HOUSTON PKWY N
Second Line :
City : HOUSTON
State : TX
Zip : 77044-0002
Country : US
Telephone Number : 346-378-7022
Fax Number :
Provider Business Practice Location Address
First Line : 11433 E SAM HOUSTON PKWY N
Second Line :
City : HOUSTON
State : TX
Zip : 77044-0002
Country : US
Telephone Number : 346-378-7022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2020
Last Update Date : 05/08/2020

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Directions to “ SHAUNA WHITE ATC” Practice Location

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