Healthcare Provider Details

I. General information

NPI: 1205770591
Provider Name (Legal Business Name): MADELINE MARTINEZ RODENBAUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 S INTERSTATE 35 E
CORINTH TX
76210-2302
US

IV. Provider business mailing address

3909 N LOOP 288 APT 5303
DENTON TX
76208-7104
US

V. Phone/Fax

Practice location:
  • Phone: 940-387-5131
  • Fax:
Mailing address:
  • Phone: 682-429-4756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: