Provider Demographics
NPI:1184015265
Name:MADDOX, SAMANTHA (LM/CPM)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:MADDOX
Suffix:
Gender:F
Credentials:LM/CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19707 AUBURN PARK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6039
Mailing Address - Country:US
Mailing Address - Phone:512-299-0139
Mailing Address - Fax:281-419-7171
Practice Address - Street 1:19707 AUBURN PARK LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6039
Practice Address - Country:US
Practice Address - Phone:512-299-0139
Practice Address - Fax:281-419-7171
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty