MEDICARE: MADISON LENOW PA

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	PA20297	TX

General Provider Information

NPI Number	:	1295685162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON LENOW PA

Provider Business Mailing Address
First Line	:	200 W MAGNOLIA AVE STE 201
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-7657
Country	:	US
Telephone Number	:	817-702-2977
Fax Number	:	817-702-2140

Provider Business Practice Location Address
First Line	:	2800 CHERRY LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-3922
Country	:	US
Telephone Number	:	817-702-2977
Fax Number	:	817-702-2140

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

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	04/07/2026

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Directions to “ MADISON LENOW PA” Practice Location

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