Provider Demographics
NPI:1821432584
Name:NORMAN, SHAUNA BUTLER (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:BUTLER
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1928 GASTON PLACE DR STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2658
Mailing Address - Country:US
Mailing Address - Phone:512-600-2234
Mailing Address - Fax:512-600-2236
Practice Address - Street 1:1928 GASTON PLACE DR STE C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2658
Practice Address - Country:US
Practice Address - Phone:512-600-2234
Practice Address - Fax:512-600-2236
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS98542080S0010X, 208000000X, 208000000X
TXBP20072796390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program