MEDICARE: NORMAND F. TREMBLAY, M.D. P.A.

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	261QM2500X	Medical Specialty Clinic/Center	E8278	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578725032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORMAND F. TREMBLAY, M.D. P.A.

Provider Business Mailing Address
First Line	:	5929 LOVELL AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-5029
Country	:	US
Telephone Number	:	817-315-2550
Fax Number	:	817-732-4660

Provider Business Practice Location Address
First Line	:	5929 LOVELL AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-5029
Country	:	US
Telephone Number	:	817-315-2550
Fax Number	:	817-732-4660

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NORMAND F. TREMBLAY
Credential	:
Telephone Number	:	817-315-2550

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	11/11/2008

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