Provider Demographics
NPI:1275907263
Name:SHROGIN, PAUL ABRAM (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ABRAM
Last Name:SHROGIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 BRODIE LN STE 202
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6284
Mailing Address - Country:US
Mailing Address - Phone:805-478-3760
Mailing Address - Fax:
Practice Address - Street 1:9701 BRODIE LN STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748
Practice Address - Country:US
Practice Address - Phone:805-478-3760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-14
Last Update Date:2018-07-12
Deactivation Date:2017-11-09
Deactivation Code:
Reactivation Date:2017-11-14
Provider Licenses
StateLicense IDTaxonomies
TX13075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor