Individual
MRS. NATHALIA WHITE SHANETTA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HEALTHCARE PROVIDER
Contact information
Practice address
240 W GALVESTON ST UNIT 417, LEAGUE CITY, TX 77574-0849
(281) 787-2881
Mailing address
240 W GALVESTON ST UNIT 417, LEAGUE CITY, TX 77574-0849
(281) 787-2881
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-5132507
—
TX
05
—
825132507
—
TX
Enumeration date
04/13/2018
Last updated
04/13/2018
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