Provider Demographics
NPI:1699076992
Name:WHYTE, ANDREW THOMAS (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:THOMAS
Last Name:WHYTE
Suffix:
Gender:M
Credentials:OD
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 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:MD ANDERSON CENTER: DEPT HEAD AND NECK SURGERY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7429TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7429TGOtherTEXAS BOARD OF OPTOMETRY LICENSE NUMBER
TX329584201Medicaid
TX80167705OtherTEXAS CONTROLLED SUBSTANCES REGISTRATION (DPS REGISTRATION)
TX329584201Medicaid