Provider Demographics
NPI:1346219821
Name:NORMAN, ALAN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:ANDREW
Last Name:NORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 S HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-1016
Mailing Address - Country:US
Mailing Address - Phone:817-529-9949
Mailing Address - Fax:817-529-9943
Practice Address - Street 1:321 S HENDERSON ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-1016
Practice Address - Country:US
Practice Address - Phone:817-529-9949
Practice Address - Fax:817-529-9943
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2508207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152778001Medicaid
IN200501680Medicaid
145291402OtherAMERIGROUP
TX8G6220OtherBCBS
BG6221OtherBCBS
H43786OtherCOOK CHIPS
TX145291402Medicaid
120481101OtherFIRST CARE STAR MEDICAID
H43786OtherCIGNA OPTICARE
7021107OtherAETNA
H43786OtherCOOK CHIPS
120481101OtherFIRST CARE STAR MEDICAID
BG6221OtherBCBS