Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 12966 | TX |
N | 111NP0017X | Pediatric Chiropractor | 12966 | TX |
NPI | 1255713673 |
---|---|
Provider Name | Jeannique Norbert |
First Address | Cedar Park, TX 78613-4330 |
Second Address | Lakeway, TX 78734-4473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 16/09/2015 |