Provider Demographics
NPI:1326806878
Name:WESTBROOK, MADISON BAILEY (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:BAILEY
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2505 W BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1930
Mailing Address - Country:US
Mailing Address - Phone:972-230-8290
Mailing Address - Fax:972-230-8274
Practice Address - Street 1:2505 W BELT LINE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1930
Practice Address - Country:US
Practice Address - Phone:972-230-8290
Practice Address - Fax:972-230-8274
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA17760363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant