Provider Demographics
NPI:1457990186
Name:BISHOP, MADISON DREU (CRNA)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:DREU
Last Name:BISHOP
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:DREU
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2117 93RD PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-4417
Mailing Address - Country:US
Mailing Address - Phone:806-252-9090
Mailing Address - Fax:
Practice Address - Street 1:3419 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1334
Practice Address - Country:US
Practice Address - Phone:806-796-3000
Practice Address - Fax:806-796-3006
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX830907163W00000X
TXAP144760367500000X
TX129335367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse