MEDICARE: MADELEINE G. CODY PA-C

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	363A00000X	Physician Assistant	PA05587	TX

General Provider Information

NPI Number	:	1285850727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELEINE G. CODY PA-C

Provider Business Mailing Address
First Line	:	5708 HIGHLAND HILLS DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4233
Country	:	US
Telephone Number	:	405-990-6640
Fax Number	:

Provider Business Practice Location Address
First Line	:	10815 RR 2222
Second Line	:	BLDG 3A
City	:	AUSTIN
State	:	TX
Zip	:	78730-1159
Country	:	US
Telephone Number	:	512-327-4262
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	09/21/2016

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