Provider Demographics
NPI:1114920022
Name:FRUGIA, SHANNON (AUD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:FRUGIA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 HOSPITAL DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4664
Mailing Address - Country:US
Mailing Address - Phone:409-981-1702
Mailing Address - Fax:409-981-1784
Practice Address - Street 1:740 HOSPITAL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4664
Practice Address - Country:US
Practice Address - Phone:409-981-1702
Practice Address - Fax:409-981-1784
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51289231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist