Provider Demographics
NPI:1548422926
Name:SCROGGINS, KRISTINA M (CSFA)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:M
Last Name:SCROGGINS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11613 SUN GLIDE LN
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-3779
Mailing Address - Country:US
Mailing Address - Phone:512-470-2091
Mailing Address - Fax:512-272-9217
Practice Address - Street 1:11613 SUN GLIDE LN
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653
Practice Address - Country:US
Practice Address - Phone:512-470-2091
Practice Address - Fax:512-272-9217
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133652246ZS0410X
246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist