MEDICARE: MRS. HERMELINDA NORWOOD D.D,S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19826	TX

General Provider Information

NPI Number	:	1346383817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HERMELINDA NORWOOD D.D,S.

Provider Business Mailing Address
First Line	:	3503 LAUREL BAY LOOP
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-1120
Country	:	US
Telephone Number	:	512-248-8249
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 E WHITESTONE BLVD
Second Line	:	SUITE 162
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-7433
Country	:	US
Telephone Number	:	512-259-6633
Fax Number	:	512-259-6590

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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