Provider Demographics
NPI:1265932875
Name:SHROYER, CAROL LARIE
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LARIE
Last Name:SHROYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 COUNTY ROAD 307
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-1156
Mailing Address - Country:US
Mailing Address - Phone:512-497-4453
Mailing Address - Fax:
Practice Address - Street 1:251 COUNTY ROAD 307
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-1156
Practice Address - Country:US
Practice Address - Phone:512-497-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant