Basic Information
Provider Information
NPI: 1841222569
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITE
FirstName: RICK
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 840862
Address2:  
City: DALLAS
State: TX
PostalCode: 752840862
CountryCode: US
TelephoneNumber: 3033777638
FaxNumber: 3037800787
Practice Location
Address1: 8000 E MAPLEWOOD AVE STE 200
Address2:  
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801114727
CountryCode: US
TelephoneNumber: 3034383999
FaxNumber: 7204399500
Other Information
ProviderEnumerationDate: 07/06/2006
LastUpdateDate: 09/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X3736-012WIN Chiropractic ProvidersChiropractor 
207R00000XR10728IAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207L00000XDR.0066676COY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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