Provider Demographics
NPI:1255503579
Name:SHECTMAN, NORTON (PA-C)
Entity Type:Individual
Prefix:
First Name:NORTON
Middle Name:
Last Name:SHECTMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 NW MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1525
Mailing Address - Country:US
Mailing Address - Phone:210-379-8666
Mailing Address - Fax:210-223-4165
Practice Address - Street 1:1222 MCCULLOUGH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4812
Practice Address - Country:US
Practice Address - Phone:201-223-4140
Practice Address - Fax:210-223-4165
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00309363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L9707Medicare PIN