MEDICARE: DR. ROBIN P SHAW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist
2	103T00000X	Psychologist	16105	TX

General Provider Information

NPI Number	:	1588778963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN P SHAW

Provider Business Mailing Address
First Line	:	1407 PALO DURO RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-3313
Country	:	US
Telephone Number	:	512-289-4646
Fax Number	:	512-853-5551

Provider Business Practice Location Address
First Line	:	1407 PALO DURO RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-3313
Country	:	US
Telephone Number	:	512-289-4646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	04/27/2021

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Directions to “ DR. ROBIN P SHAW ” Practice Location

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