Provider Demographics
NPI:1063019917
Name:ROBINSON, SHAYLA (DPM)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S JOHN REDDITT DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3112
Mailing Address - Country:US
Mailing Address - Phone:936-632-5252
Mailing Address - Fax:
Practice Address - Street 1:1887 HUDSON XING APT 9
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5661
Practice Address - Country:US
Practice Address - Phone:903-722-3649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3149213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist