MEDICARE: KIMBERLY 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
1	246XS1301X	Sonography Specialist/Technologist Cardiovascular	00144811	TX

General Provider Information

NPI Number	:	1962360594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY WHITE

Provider Business Mailing Address
First Line	:	3939 US HIGHWAY 80 E STE 455
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-3355
Country	:	US
Telephone Number	:	972-903-5148
Fax Number	:

Provider Business Practice Location Address
First Line	:	3939 US HIGHWAY 80 E STE 455
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-3355
Country	:	US
Telephone Number	:	972-903-5148
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ KIMBERLY WHITE ” Practice Location

Language	Start Address	Practice Location

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