Provider Demographics
NPI:1194423046
Name:WHITE, BARBARA LYNNE
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 STONE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-1885
Mailing Address - Country:US
Mailing Address - Phone:682-221-3568
Mailing Address - Fax:
Practice Address - Street 1:2216 EASTOVER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76105-2602
Practice Address - Country:US
Practice Address - Phone:682-221-3568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care