MEDICARE: MADISON RAINES

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

General Provider Information

NPI Number	:	1740914415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON RAINES

Provider Business Mailing Address
First Line	:	9722 GREAT HILLS TRL # 375
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7263
Country	:	US
Telephone Number	:	512-240-9498
Fax Number	:

Provider Business Practice Location Address
First Line	:	9722 GREAT HILLS TRL # 375
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7263
Country	:	US
Telephone Number	:	512-240-9498
Fax Number	:

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

Provider Enumeration Date	:	07/10/2022
Last Update Date	:	12/15/2025

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Directions to “ MADISON RAINES ” Practice Location

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