Provider Demographics
NPI:1780400697
Name:MADDEN, CATIE (RD, LD, CNSC)
Entity type:Individual
Prefix:MRS
First Name:CATIE
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:RD, LD, CNSC
Other - Prefix:
Other - First Name:MARY-CATHERINE
Other - Middle Name:
Other - Last Name:MADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD, CNSC
Mailing Address - Street 1:7238 HOLYOKE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2239
Mailing Address - Country:US
Mailing Address - Phone:713-299-6690
Mailing Address - Fax:
Practice Address - Street 1:3417 GASTON AVE STE 965
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2036
Practice Address - Country:US
Practice Address - Phone:972-817-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81362133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered