Provider Demographics
NPI:1356342182
Name:MADSEN, HOWARD F (RD, PHARMD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:F
Last Name:MADSEN
Suffix:
Gender:M
Credentials:RD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 110TH ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-0813
Mailing Address - Country:US
Mailing Address - Phone:806-368-8173
Mailing Address - Fax:806-368-8173
Practice Address - Street 1:3111 110TH ST
Practice Address - Street 2:UNIT B
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-0813
Practice Address - Country:US
Practice Address - Phone:806-368-8173
Practice Address - Fax:806-368-8173
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43428183500000X, 1835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support