Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 48631 | MN |
N | 208600000X | Surgeon | 48631 | MN |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD448650 | PA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | Q2138 | TX |
NPI | 1073657235 |
---|---|
Provider Name | Shawn Spencer Groth |
First Address | Houston, TX 77030-2348 |
Second Address | Houston, TX 77030-2348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 13/11/2020 |