Individual
COLBIE CROSS NORMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
305 W 20TH ST, MT PLEASANT, TX 75455-2327
(903) 939-7500
(903) 939-7728
Mailing address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 939-7728
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370095702
—
TX
01
—
623447YNSX
MEDICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
75-2616977-129
TRICARE
TX
01
—
8GM012
BCBS
TX
01
—
P01967493
MEDICARE RAIL ROAD
TX
Enumeration date
08/31/2015
Last updated
07/02/2020
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