Provider Demographics
NPI:1114296936
Name:NORMAN, ROY EDWARD JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:EDWARD
Last Name:NORMAN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 732672
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4658
Mailing Address - Country:US
Mailing Address - Phone:281-351-4911
Mailing Address - Fax:
Practice Address - Street 1:308 HOLDERRIETH BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4536
Practice Address - Country:US
Practice Address - Phone:281-351-4911
Practice Address - Fax:281-351-4915
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-2393207RC0000X
TXQ7937207RC0000X
TXBP10051681207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease