Provider Demographics
NPI:1013953736
Name:ANDERSON, NORMA ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:ELIZABETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 CAT HOLLOW DR 205
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5799
Mailing Address - Country:US
Mailing Address - Phone:512-218-4900
Mailing Address - Fax:
Practice Address - Street 1:7700 CAT HOLLOW DR STE 205
Practice Address - Street 2:
Practice Address - City:ROUNDROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-218-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G13929Medicare UPIN
TX8F5204Medicare PIN