Provider Demographics
NPI:1962500959
Name:NORMAN, WILLIAM BARRY (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BARRY
Last Name:NORMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 OVERTON PLZ
Mailing Address - Street 2:SUITE 320
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4428
Mailing Address - Country:US
Mailing Address - Phone:817-731-0888
Mailing Address - Fax:817-259-1651
Practice Address - Street 1:4800 OVERTON PLZ
Practice Address - Street 2:SUITE 320
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4428
Practice Address - Country:US
Practice Address - Phone:817-731-0888
Practice Address - Fax:817-259-1651
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1556103TC2200X, 103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic