Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | J3861 | TX |
N | 2080P0203X | Pediatric Critical Care Doctor | J3861 | TX |
NPI | 1114008877 |
---|---|
Provider Name | William John Norberg JR. |
First Address | Mcallen, TX 78502-3823 |
Second Address | Edinburg, TX 78539-9105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D 26171 | (02) |