Individual
DR. BRYAN KEITH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 S HALL ST, ENNIS, TX 75119-6318
(541) 799-4769
(972) 502-9191
Mailing address
5613 HERON DR E, COLLEYVILLE, TX 76034-2503
(541) 799-4441
(972) 502-9191
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J4607
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125214003
—
TX
01
—
82V273
BCBS
TX
Enumeration date
09/20/2006
Last updated
04/19/2022
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