Provider Demographics
NPI:1841371424
Name:WHISENANT, NORMAN M (DO)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:M
Last Name:WHISENANT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 C SOUTH BUSINESS IH 35 #44
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130
Mailing Address - Country:US
Mailing Address - Phone:210-710-4265
Mailing Address - Fax:830-620-0330
Practice Address - Street 1:614 C SOUTH BUSINESS IH 35 #44
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:210-710-4265
Practice Address - Fax:830-620-5405
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3948208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188974301Medicaid