Provider Demographics
NPI:1952906794
Name:MADISON, BARBARA (RPH)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MADISON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-3912
Mailing Address - Country:US
Mailing Address - Phone:281-592-5279
Mailing Address - Fax:
Practice Address - Street 1:108 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-3912
Practice Address - Country:US
Practice Address - Phone:281-592-5279
Practice Address - Fax:281-592-5733
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist