Provider Demographics
NPI:1558096586
Name:STUBBS, MADYSON CLAIRE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MADYSON
Middle Name:CLAIRE
Last Name:STUBBS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 GATTIS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-2025
Mailing Address - Country:US
Mailing Address - Phone:512-251-3173
Mailing Address - Fax:
Practice Address - Street 1:5000 GATTIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2025
Practice Address - Country:US
Practice Address - Phone:512-251-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist