Provider Demographics
NPI:1639701832
Name:MADDOX, DONDEE MARIE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DONDEE
Middle Name:MARIE
Last Name:MADDOX
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2747
Mailing Address - Country:US
Mailing Address - Phone:210-247-8795
Mailing Address - Fax:
Practice Address - Street 1:6363 DE ZAVALA RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2104
Practice Address - Country:US
Practice Address - Phone:210-399-4838
Practice Address - Fax:210-877-9279
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143788363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health