Provider Demographics
NPI:1831483106
Name:NORTON, FREDERICK EUGENE
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:EUGENE
Last Name:NORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 OVERTON RIDGE BLVD
Mailing Address - Street 2:T-1770
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3220
Mailing Address - Country:US
Mailing Address - Phone:817-423-1661
Mailing Address - Fax:817-423-1661
Practice Address - Street 1:5700 OVERTON RIDGE BLVD
Practice Address - Street 2:T-1770
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3220
Practice Address - Country:US
Practice Address - Phone:817-423-1661
Practice Address - Fax:817-423-1661
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist