Provider Demographics
NPI:1144664657
Name:WHITE, SANDRA GILL (MS)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:GILL
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6301 CAMPUS CIRCLE DR E
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2712
Mailing Address - Country:US
Mailing Address - Phone:469-374-0700
Mailing Address - Fax:469-374-0800
Practice Address - Street 1:6301 CAMPUS CIRCLE DR E
Practice Address - Street 2:SUITE 100A
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2712
Practice Address - Country:US
Practice Address - Phone:469-374-0700
Practice Address - Fax:469-374-0800
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist