Provider Demographics
NPI:1386936938
Name:MADDEN, DEBBIE M (MS, RD, LD, CDE, CPT)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:M
Last Name:MADDEN
Suffix:
Gender:F
Credentials:MS, RD, LD, CDE, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3027
Mailing Address - Country:US
Mailing Address - Phone:281-265-6222
Mailing Address - Fax:
Practice Address - Street 1:2715 OAKLAND DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3027
Practice Address - Country:US
Practice Address - Phone:281-265-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04118133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered