Individual
JAN BIRDWELL-WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1534 LATIGO LN, FLOWER MOUND, TX 75022-6589
(214) 536-8670
Mailing address
1534 LATIGO LN, FLOWER MOUND, TX 75022-6589
(214) 536-8670
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA09273
TX
363AS0400X
Surgical Physician Assistant
PA09273
TX
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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