Provider Demographics
NPI:1336156157
Name:WHITE, DARLA (PT)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DARLA
Other - Middle Name:
Other - Last Name:KALB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:485 CHAMA TRCE
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5311
Mailing Address - Country:US
Mailing Address - Phone:512-497-4885
Mailing Address - Fax:512-894-2122
Practice Address - Street 1:485 CHAMA TRCE
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5311
Practice Address - Country:US
Practice Address - Phone:512-497-4885
Practice Address - Fax:512-894-2122
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1114379225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6222OtherBLUE CROSS & BLUE SHIELD