Provider Demographics
NPI:1104921329
Name:WHITE, ELIZABETH RITCHEY (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RITCHEY
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:E
Other - Last Name:RITCHEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1423 N WALNUT AVE
Mailing Address - Street 2:#103
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6010
Mailing Address - Country:US
Mailing Address - Phone:830-626-0501
Mailing Address - Fax:830-627-2254
Practice Address - Street 1:1423 N WALNUT AVE
Practice Address - Street 2:# 103
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6009
Practice Address - Country:US
Practice Address - Phone:830-626-0501
Practice Address - Fax:830-627-2254
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6604207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121419901Medicaid
TX0073ETOtherBLUE CROSS
TX00832LMedicare PIN
TX0073ETOtherBLUE CROSS