Healthcare Provider Details

I. General information

NPI: 1609041003
Provider Name (Legal Business Name): WHITEGLOVE HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S MOPAC BUILDING 2, SUITE 450
AUSTIN TX
78746-7009
US

IV. Provider business mailing address

1601 S MOPAC BUILDING 2, SUITE 450
AUSTIN TX
78746-7009
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-9223
  • Fax: 512-329-8281
Mailing address:
  • Phone: 512-329-9223
  • Fax: 512-329-8281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBRA DEERWESTER
Title or Position: CHIEF CLINICAL OFFICER
Credential: DNP
Phone: 512-329-8081