Provider Demographics
NPI:1730932989
Name:WHITE, NOELLE JOAN (DC)
Entity type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:JOAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S MARLBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-7414
Mailing Address - Country:US
Mailing Address - Phone:315-741-2893
Mailing Address - Fax:
Practice Address - Street 1:515 S MARLBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-7414
Practice Address - Country:US
Practice Address - Phone:315-741-2893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor