Healthcare Provider Details

I. General information

NPI: 1982277919
Provider Name (Legal Business Name): ROBERT B WHITE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WBAMC/DEPT OF MEDICINE/IM TRAINING PROGRAM/GME 5005 N PIEDRAS STREET
EL PASO TX
79920-5001
US

IV. Provider business mailing address

WBAMC/DEPT OF MEDICINE/IM TRAINING PROGRAM/GME 5005 N PIEDRAS STREET
EL PASO TX
79920-5001
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-2180
  • Fax: 915-742-4363
Mailing address:
  • Phone: 915-742-2180
  • Fax: 915-742-4363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number010217
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberU7538
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number010217
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: