Individual
BRIAN T NORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
12523 S CREEK MEADOW RD STE 109, RIVERTON, UT 84065-7299
(801) 251-0735
(512) 583-1099
Mailing address
1015 E 32ND ST, SUITE 200, AUSTIN, TX 78705-2707
(512) 476-2830
(512) 583-1099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9557601-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
9557601-1206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9557601-1206
HEALTH AND WELLNESS
UT
01
—
PA04216
STATE LICENSE NUMBER
TX
Enumeration date
06/16/2006
Last updated
11/12/2024
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