Individual
MR. HARRY WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
8750 PHELAN BLVD, BEAUMONT, TX 77706-5133
(409) 981-7492
Mailing address
915 MEADOWLAND DR, BEAUMONT, TX 77706
(409) 860-4067
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
465
TX
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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