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General NPI Number Information
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NPI Number | 1407925845
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Entity Type | Individual
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Provider Name | STEPHANIE MARY WHITE O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/14/2021
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Provider Practice Location Address
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Address Line | 5110 JEFFERSON HWY VISION CENTER
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City | HARAHAN
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State | LA
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Zip | 70123-5302
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Country | US
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Telephone | 504-818-1463
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Fax |
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Provider Business Mailing Address
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Address Line | 212 RUE LANDRY
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City | SAINT ROSE
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State | LA
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Zip | 70087-3666
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Country | US
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Telephone | 504-710-1129
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1269-423T
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License Number State | LA
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