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1194789883

NPI Code Detail

MEDICARE: DR. DAN FREDERICK MADSEN MD

MEDICARE: DR. DAN FREDERICK MADSEN MD

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	207Y00000X	Otolaryngology Physician	F6897	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	040006014	OTHER	TX	RAILROAD GBA - RAILROAD MEDICARE
5	P01090504	OTHER	TX	RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	887915	OTHER	TX	BC/BS TX#
4	MDF6897TX	OTHER	TX	WORKERS COMPENSATION
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	8DE536	OTHER	TX	BC/BS #

General Provider Information

NPI Number	:	1194789883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN FREDERICK MADSEN MD

Provider Business Mailing Address
First Line	:	2100 REGIONAL MEDICAL DR
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-9719
Country	:	US
Telephone Number	:	979-532-1700
Fax Number	:	979-532-6796

Provider Business Practice Location Address
First Line	:	2100 REGIONAL MEDICAL DR
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-9719
Country	:	US
Telephone Number	:	979-532-1700
Fax Number	:	979-532-6796

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	12/05/2012

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Directions to “ DR. DAN FREDERICK MADSEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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