Provider Demographics
NPI:1528114766
Name:NORMAN, MICHAEL J (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:NORMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 N JOSEY LN
Mailing Address - Street 2:STE. 216
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2474
Mailing Address - Country:US
Mailing Address - Phone:972-394-3350
Mailing Address - Fax:972-395-3628
Practice Address - Street 1:3740 N JOSEY LN
Practice Address - Street 2:STE. 216
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2474
Practice Address - Country:US
Practice Address - Phone:972-394-3350
Practice Address - Fax:972-395-3628
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5993111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-2443943OtherEMPLOYER ID
TX5993OtherTEXAS LICENSE NUMBER