Provider Demographics
NPI:1679689160
Name:WHITE, LINDSAY HERBERT (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:HERBERT
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:PO BOX 460489
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78246-0489
Mailing Address - Country:US
Mailing Address - Phone:210-222-0137
Mailing Address - Fax:210-222-0719
Practice Address - Street 1:2011 E HOUSTON
Practice Address - Street 2:SUITE E
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78202-2912
Practice Address - Country:US
Practice Address - Phone:210-222-0137
Practice Address - Fax:210-222-0719
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742822816OtherTAX ID
TX1003204-01Medicaid
TXJ7726Medicaid
TX00U31DMedicare UPIN
TX1003204-01Medicaid