Provider Demographics
NPI:1023164977
Name:WHITE, CHRISTOPHER ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12709 TOEPPERWEIN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3260
Mailing Address - Country:US
Mailing Address - Phone:210-653-9307
Mailing Address - Fax:210-653-7014
Practice Address - Street 1:12709 TOEPPERWEIN RD STE 302
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3260
Practice Address - Country:US
Practice Address - Phone:210-653-9307
Practice Address - Fax:210-653-7014
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK57412086S0102X, 2086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199093903Medicaid
TX813524OtherMEDICARE PTAN