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NPI Code Detail

MEDICARE: VICTORIA WHITE

MEDICARE: VICTORIA WHITE
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
1183500000XPharmacist69282TX

General Provider Information

NPI Number : 1245992403
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA WHITE
Provider Business Mailing Address
First Line : 3907 GILBERT AVE APT 1
Second Line :
City : DALLAS
State : TX
Zip : 75219-3806
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12300 LAKE JUNE RD
Second Line :
City : BALCH SPRINGS
State : TX
Zip : 75180-1636
Country : US
Telephone Number : 972-281-0180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2021
Last Update Date : 10/06/2021

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Directions to “ VICTORIA WHITE ” Practice Location

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