Individual
KENNETH STEPHEN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3410 FAR WEST BLVD, SUITE 100, AUSTIN, TX 78731-3194
(512) 346-5735
(512) 233-2792
Mailing address
3410 FAR WEST BLVD, SUITE 100, AUSTIN, TX 78731-3194
(512) 346-5735
(512) 233-2792
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2229
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B06002321
—
TX
01
—
BC/BS OF TEXAS
BC/BS ID
TX
01
—
DC2229
LICENSE ID
TX
Enumeration date
03/25/2006
Last updated
02/26/2014
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