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General NPI Number Information
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NPI Number | 1053509802
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Entity Type | Organization
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Legal Business Name | LENAE WHITE, M.D., P.A.
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 8222 DOUGLAS AVE STE. 390
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City | DALLAS
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State | TX
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Zip | 75225-5923
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Country | US
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Telephone | 214-234-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 8222 DOUGLAS AVE STE. 390
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City | DALLAS
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State | TX
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Zip | 75225-5923
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | CALLIE LILES
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Credential | LCSW
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Telephone | 214-234-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | L7601
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License Number State | TX
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