Provider Demographics
NPI:1932843042
Name:SCRUGGS, CAROLINE KEENER
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:KEENER
Last Name:SCRUGGS
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 1:801 E BEACH DR UNIT TW312
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-3372
Mailing Address - Country:US
Mailing Address - Phone:409-789-0619
Mailing Address - Fax:
Practice Address - Street 1:6400 FANNIN ST STE 2850
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1540
Practice Address - Country:US
Practice Address - Phone:713-486-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program