Provider Demographics
NPI:1770980898
Name:SCOTT, MADDIE
Entity type:Individual
Prefix:
First Name:MADDIE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 FOUNTAIN VIEW DR STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4834
Mailing Address - Country:US
Mailing Address - Phone:713-880-4400
Mailing Address - Fax:
Practice Address - Street 1:1910 QUAKER AVE STE 101
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2433
Practice Address - Country:US
Practice Address - Phone:806-725-4440
Practice Address - Fax:806-725-4441
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185416363LF0000X
NY350983363LF0000X
TXAP126805363LF0000X
NJ26NJ14905900363LF0000X
NC5017263363LF0000X
AZ283321363LF0000X
CA95023722363LF0000X
CT11025363LF0000X
MI4704396051363LF0000X
IL209026209363LF0000X
OK210940363LF0000X
PASP027767363LF0000X
FLTPAN1090363LF0000X
KS81615363LF0000X
GAGAA-NP001169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily