Provider Demographics
NPI:1487899951
Name:WHITE, ASHA M (ACNS-BC)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 651
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-820-8500
Mailing Address - Fax:214-820-8168
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 651
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-820-8500
Practice Address - Fax:214-820-8168
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX687706364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200242002Medicaid
TX200242003Medicaid
TX2002420-01Medicaid
TX200242002Medicaid
TX2002420-01Medicaid
TX8L8608Medicare PIN