Doctor Name: | DR. PAUL SHRODE |
NPI Number: | 1801195847 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | J2328 |
Business Practice Address: | 9627 Randon Ln Missouri City, TX - 774596209 |
Business Phone Number: | 9152404066 |
Business Fax Number: | |
Mailing Address: | 2898 E County Road 1000 N, CHRISNEY |
State: | IN |
Postal Code: | 476119402 |
Phone Number: | 9152404066 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2011 |
NPI Last Update Date: | 03/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | J2328 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |