Provider Demographics
NPI:1609041003
Name:WHITEGLOVE HEALTH, INC.
Entity type:Organization
Organization Name:WHITEGLOVE HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEERWESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:512-329-8081
Mailing Address - Street 1:1601 S MOPAC
Mailing Address - Street 2:BUILDING 2, SUITE 450
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7009
Mailing Address - Country:US
Mailing Address - Phone:512-329-9223
Mailing Address - Fax:512-329-8281
Practice Address - Street 1:1601 S MOPAC
Practice Address - Street 2:BUILDING 2, SUITE 450
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7009
Practice Address - Country:US
Practice Address - Phone:512-329-9223
Practice Address - Fax:512-329-8281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service