Individual
JEFFERY RANDALL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6901 MEDICAL PKWY, RADIOLOGY DEPARTMENT, WACO, TX 76712-7910
(254) 751-4299
(903) 663-7394
Mailing address
4777 US HIGHWAY 259, LONGVIEW, TX 75605-7668
(903) 663-7393
(903) 663-7394
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
P2932
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302494501
—
TX
Enumeration date
06/07/2007
Last updated
08/19/2013
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