Provider Demographics
NPI:1881063964
Name:NORBERT ENTERPRISES, PLLC
Entity type:Organization
Organization Name:NORBERT ENTERPRISES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-697-0515
Mailing Address - Street 1:2306 PIPIT CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1202 LAKEWAY DR
Practice Address - Street 2:SUITE 14
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-4473
Practice Address - Country:US
Practice Address - Phone:214-697-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12966261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center