Provider Demographics
NPI:1720022320
Name:SMALL, HENRY NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:NORMAN
Last Name:SMALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 FANNIN ST
Mailing Address - Street 2:STE. 710
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1938
Mailing Address - Country:US
Mailing Address - Phone:281-389-5271
Mailing Address - Fax:713-842-7911
Practice Address - Street 1:7501 FANNIN ST
Practice Address - Street 2:STE. 710
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1938
Practice Address - Country:US
Practice Address - Phone:281-389-5271
Practice Address - Fax:713-842-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3942207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00674758OtherRAILROAD MEDICARE
TXP01037433OtherRAILROAD
TX8L3890OtherMEDICARE PTAN- RBJC
TX128497806Medicaid
TX128497807Medicaid
TX128497808Medicaid
TX128497810Medicaid
TX128497809Medicaid
TXTXB143820Medicare PIN
TXP00674758OtherRAILROAD MEDICARE
TX8L3890OtherMEDICARE PTAN- RBJC
TXF32791Medicare UPIN
TX128497807Medicaid
TXTXB143820Medicare PIN