MEDICARE: MADISON NOEL SCHUH PTA

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	225200000X	Physical Therapy Assistant	2170397	TX

General Provider Information

NPI Number	:	1194453332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON NOEL SCHUH PTA

Provider Business Mailing Address
First Line	:	40609 ROUNDUP RD
Second Line	:
City	:	MAGNOLIA
State	:	TX
Zip	:	77354-1418
Country	:	US
Telephone Number	:	281-841-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	18001 HIGHWAY 105 W STE 106
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77356-2881
Country	:	US
Telephone Number	:	936-582-2464
Fax Number	:

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

Provider Enumeration Date	:	08/14/2022
Last Update Date	:	04/26/2024

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