MEDICARE: RONALD L NORSWORTHY INC

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	174400000X	Specialist	008373	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
2	008373	OTHER	TX	PAS LICENSE

General Provider Information

NPI Number	:	1629191283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD L NORSWORTHY INC

Provider Business Mailing Address
First Line	:	19901 SOUTHWEST FWY
Second Line	:	SUITE 245
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6538
Country	:	US
Telephone Number	:	281-207-5359
Fax Number	:	281-207-5349

Provider Business Practice Location Address
First Line	:	19901 SOUTHWEST FWY
Second Line	:	SUITE 245
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6538
Country	:	US
Telephone Number	:	281-207-5359
Fax Number	:	281-207-5349

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RONALD LAMOND NORSWORTHY
Credential	:	B.A. MBA. CSA
Telephone Number	:	281-207-5359

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	06/13/2008

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