MEDICARE: JOHN ANTHONY NORRIS MD

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	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	E4570	TX
2	2086S0127X	Trauma Surgery Physician	E4570	TX
3	208600000X	Surgery Physician	E4570	TX
4	2086S0102X	Surgical Critical Care Physician	E4570	TX
5	2086S0129X	Vascular Surgery Physician	E4570	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8R7270	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982678694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANTHONY NORRIS MD

Provider Business Mailing Address
First Line	:	PO BOX 846098
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6098
Country	:	US
Telephone Number	:	903-324-6450
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 E HOUSTON ST
Second Line	:	STE 530
City	:	TYLER
State	:	TX
Zip	:	75702-8369
Country	:	US
Telephone Number	:	903-531-5560
Fax Number	:

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	02/26/2024

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