Provider Demographics
NPI:1568484277
Name:SHULMAN, NORMAN MARK (EDD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:MARK
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 6TH ST. A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-4700
Mailing Address - Country:US
Mailing Address - Phone:806-793-7491
Mailing Address - Fax:806-793-4780
Practice Address - Street 1:4401 A 6TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416
Practice Address - Country:US
Practice Address - Phone:806-793-7491
Practice Address - Fax:806-793-4780
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24018103TC0700X
NH216103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098515202Medicaid
TX098515202Medicaid