Provider Demographics
NPI:1215193578
Name:POORMAN, NORMAN P (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:P
Last Name:POORMAN
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 S WILLIS ST
Mailing Address - Street 2:STE C
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6287
Mailing Address - Country:US
Mailing Address - Phone:325-692-9557
Mailing Address - Fax:325-692-8316
Practice Address - Street 1:2501 S WILLIS ST
Practice Address - Street 2:STE C
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6287
Practice Address - Country:US
Practice Address - Phone:325-692-9557
Practice Address - Fax:325-692-8316
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316083462OtherCORPORATE NPI