Provider Demographics
NPI:1699080093
Name:NORMILE, SCOTT O'NEAL (PT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:O'NEAL
Last Name:NORMILE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8027 FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-4126
Mailing Address - Country:US
Mailing Address - Phone:214-342-5624
Mailing Address - Fax:
Practice Address - Street 1:375 MUNICIPAL DR STE 108
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3543
Practice Address - Country:US
Practice Address - Phone:214-675-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1147981225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist