Healthcare Provider Details

I. General information

NPI: 1205938164
Provider Name (Legal Business Name): MADELINE W. HARFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11551 FOREST CENTRAL DR STE 110
DALLAS TX
75243-3984
US

IV. Provider business mailing address

25112 MOBERLY CT
LAGUNA NIGUEL CA
92677-8879
US

V. Phone/Fax

Practice location:
  • Phone: 214-537-9656
  • Fax:
Mailing address:
  • Phone: 214-537-9656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE0206
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC175699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: