Individual provider Active NPI

Laura Elizabeth White, P.A.-C.

  • Physician Assistant
  • Irving, TX
National Provider Identifier
1649371238
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03969 Issued in TX
Practice address
400 W Ih 635 Fwy
Plaza I, Suite 220
Irving, TX 75063-3718
Phone
(972) 481-6363
Fax
(972) 406-2732
NPI assigned
Sep 26, 2006
Last updated
Oct 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03969 TX Primary

Addresses

Primary practice location

400 W Ih 635 Fwy
Plaza I, Suite 220
Irving, TX 75063-3718

Mailing address

5536 Forest LN
Dallas, TX 75230-2628
Phone (214) 232-5180

Other identifiers 3

IdentifierTypeStateIssuer
280814904MedicaidTX
280814901MedicaidTX
280814902MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070222000698 TX Practitioner - Physician Assistant 9638271588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 10, 2012 Accepting new patients
Healthtexas Provider Network CurrentSince Dec 10, 2012 Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

400 W Lyndon B Johnson Fwy
Ste 220
Irving, TX 75063
Phone (972) 481-6363

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1649371238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302628",
            "telephone_number": "214-232-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W IH 635 FWY",
            "address_2": "PLAZA I, SUITE 220",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633718",
            "telephone_number": "972-481-6363",
            "fax_number": "972-406-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280814904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280814901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280814902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.