Provider Demographics
NPI:1912962234
Name:WHITE, ANGELA FLANERY (AUD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:FLANERY
Last Name:WHITE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21715 KINGSLAND BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2544
Mailing Address - Country:US
Mailing Address - Phone:281-578-7500
Mailing Address - Fax:
Practice Address - Street 1:21715 KINGSLAND BLVD STE 105
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2544
Practice Address - Country:US
Practice Address - Phone:281-578-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14784235Z00000X
TX50823231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168759202Medicaid
TX168759201Medicaid
TX528477OtherBLUE CROSS BLUE SHIELD
TX168759203Medicaid
TX168759201Medicaid