MEDICARE: MR. TERRY LEE MADRID

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	224Z00000X	Occupational Therapy Assistant	215501	TX

General Provider Information

NPI Number	:	1588597280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TERRY LEE MADRID

Provider Business Mailing Address
First Line	:	PO BOX 1138
Second Line	:
City	:	SAN ELIZARIO
State	:	TX
Zip	:	79849-1138
Country	:	US
Telephone Number	:	915-373-8783
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 1138
Second Line	:
City	:	SAN ELIZARIO
State	:	TX
Zip	:	79849-1138
Country	:	US
Telephone Number	:	915-373-8783
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ MR. TERRY LEE MADRID ” Practice Location

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