# FREDRICK SHAW DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shoal Creek Prosthodontic Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073716338
- **Authorized official:** MR. ADRIAN F RAMOS (INSURANCE COORDINATOR)
- **Authorized official phone:** (512) 451-7491

## Contact information

- **Practice address:** 1500 W 38TH ST, STE. 34, AUSTIN, TX 78731-6321
- **Practice address phone:** (512) 451-7491
- **Practice address fax:** (512) 451-5388
- **Mailing address:** 1500 W 38TH ST, STE. 34, AUSTIN, TX 78731-6321
- **Mailing address phone:** (512) 451-7491
- **Mailing address fax:** (512) 451-5388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 17867 | TX | Yes |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 06/18/2008