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Organization
J. M. WHITE, OD & ASSOCIATES, PA
Active
Organization
J. M. WHITE, OD & ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MIKE WHITE O.D. (OPTOMETRIST-PRESIDENT)
(817) 594-9191
Entity
Organization
Contact information
Practice address
4088 E. IH 20 SERVICE RD., WILLOW PARK, TX 76087
(817) 594-9191
(817) 594-9190
Mailing address
4088 E. IH 20 SERVICE RD., WILLOW PARK, TX 76087
(817) 594-9191
(817) 594-9190
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2770TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0098FC
BCBS GROUP
TX
01
—
7462322
AETNA
TX
01
—
80896Q
BCBS
TX
01
—
DA5868
PALMETTO GRP
TX
01
—
P0064159
PALMETTO RAILROAD
TX
Enumeration date
03/16/2007
Last updated
02/04/2008
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