Individual provider Active NPI

Marylin H White, M. D.

  • Ophthalmology Physician
  • Wichita Falls, TX
National Provider Identifier
1477514875
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
H8892 Issued in TX
Practice address
1704 11TH St
Wichita Falls, TX 76301-5020
Phone
(940) 723-1274
Fax
(940) 723-1525
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X H8892 TX Primary

Addresses

Primary practice location

1704 11TH St
Wichita Falls, TX 76301-5020

Mailing address

1704 11TH St
Wichita Falls, TX 76301-5020
Phone (940) 723-1274

Other identifiers 1

IdentifierTypeStateIssuer
110231102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000440 TX Practitioner - Ophthalmology 5698954717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8892TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texoma Outpatient Surgery Center, Inc. Current Accepting new patients
United Regional Health Care System Inc Current Accepting new patients
North Texas Ophthalmology Associates, PLLC Ophthalmology CurrentSince Nov 1, 2021 Accepting new patients

Locations

1704 11th St
Wichita Falls, TX 76301
Phone (940) 723-1274

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: mwhite14986@unitedregional.medalliesdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1477514875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 11TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015020",
            "telephone_number": "940-723-1274",
            "fax_number": "940-723-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 11TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015020",
            "telephone_number": "940-723-1274",
            "fax_number": "940-723-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARYLIN",
        "middle_name": "H",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "H8892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110231102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.