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NPI Code Detail

MEDICARE: ABIGAIL JOY MADDEN MS, RD, LD

MEDICARE: ABIGAIL JOY MADDEN MS, RD, LD
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
1133V00000XRegistered Dietitian85541TX

General Provider Information

NPI Number : 1285118711
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL JOY MADDEN MS, RD, LD
Provider Business Mailing Address
First Line : 5415 LAMONTE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77092-5600
Country : US
Telephone Number : 806-886-1301
Fax Number :
Provider Business Practice Location Address
First Line : 2180 NORTH LOOP W STE 120
Second Line :
City : HOUSTON
State : TX
Zip : 77018-8014
Country : US
Telephone Number : 650-770-9243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2018
Last Update Date : 12/06/2023

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