Provider Demographics
NPI:1790961241
Name:NORRIS, BRIAN M (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:NORRIS
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 1:6160 WINDHAVEN PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8099
Mailing Address - Country:US
Mailing Address - Phone:972-378-6908
Mailing Address - Fax:972-473-9800
Practice Address - Street 1:6160 WINDHAVEN PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8099
Practice Address - Country:US
Practice Address - Phone:972-378-6908
Practice Address - Fax:972-473-9800
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05489363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA05489OtherSTATE