Provider Demographics
NPI:1205938164
Name:HARFORD, MADELINE W (MD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:W
Last Name:HARFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25112 MOBERLY CT
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8879
Mailing Address - Country:US
Mailing Address - Phone:214-537-9656
Mailing Address - Fax:
Practice Address - Street 1:11551 FOREST CENTRAL DR STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3984
Practice Address - Country:US
Practice Address - Phone:214-537-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE02062084P0800X
CAC1756992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC16599Medicare UPIN