Provider Demographics
NPI:1528074861
Name:NORRIS, ROBERT W (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:NORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6210 E HWY 290 STE 240
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1144
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:512-403-6216
Practice Address - Street 1:27600 RANCH ROAD 12 BLDG 1
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5612
Practice Address - Country:US
Practice Address - Phone:512-829-9118
Practice Address - Fax:512-406-7301
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3653207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135204910Medicaid
TX135204909Medicaid
TX8K0665Medicare PIN
TX135204910Medicaid
TX8B9098Medicare PIN