Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP137338 | TX |
NPI | 1013409978 |
---|---|
Provider Name | Madison Bailey Webb |
First Address | Austin, TX 78723-2245 |
Second Address | Austin, TX 78758-5653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 05/06/2018 |