NPIMap

Organization Active NPI

David and Delores White

  • Community/Behavioral Health Agency
  • Victoria, TX
National Provider Identifier
1174076046
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
66862 Issued in TX
Legal business name
DAVID AND DELORES WHITE
Practice address
4702 N Laurent St
Suite D
Victoria, TX 77904-2147
Phone
(361) 572-0202
Fax
(361) 572-0300
NPI assigned
Jul 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Delores Evens White, M.A., LPCNPI 1346597341
Title
Director
Phone
(361) 572-0202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 66862 TX Primary

Addresses

Primary practice location

4702 N Laurent St
Suite D
Victoria, TX 77904-2147

Mailing address

4702 N Laurent St
Suite D
Victoria, TX 77904-2147
Phone (361) 572-0202

Other identifiers 1

IdentifierTypeStateIssuer
305544401MedicaidTX

Other names 1

  • Popcorn Plus Doing business as

National Provider Directory

National Provider Directory

Locations

4702 N Laurent St
Ste D
Victoria, TX 77904
Phone (361) 489-0212

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1174076046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 N LAURENT ST",
            "address_2": "SUITE D",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042147",
            "telephone_number": "361-572-0202",
            "fax_number": "361-572-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 N LAURENT ST",
            "address_2": "SUITE D",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042147",
            "telephone_number": "361-572-0202",
            "fax_number": "361-572-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID AND DELORES WHITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DELORES",
        "authorized_official_middle_name": "EVENS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "361-572-0202",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A., LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "66862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305544401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Popcorn Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.