SAMUEL LEATHEN MADSON (NPI# 1699064220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699064220 |
| Entity Type | Individual |
| Full Name | SAMUEL LEATHEN MADSON |
| Credential | M.D. |
| Practice Address |
1100 Wilford Hall Loop Bldg 4554 Lackland Afb TX 78236-5638 |
| Mailing Address |
3851 Roger Brooke Dr. Brooke Army Medical Center Mche-zpr Fort Sam Houston TX 78234-6200 |
| Practice Telephone | 2109163808 |
| Mailing Telephone | 2109163808 |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2018-04-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 27143 | NE | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3851 Roger Brooke Dr, Brooke Army Medical Center Mche-zpr, Fort Sam Houston, TX 782344501 | 2109163808 |
| Street Address |
1100 WILFORD HALL LOOP BLDG 4554 |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457834277 | Michael Ryan Donohue | Physical Therapist | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638 | 2018-09-07 |
| 1992201446 | Michael Adrian Watson | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236 | 2018-04-03 |
| 1306348917 | Elias Z Tohme | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638 | 2018-02-28 |
| 1619359098 | Tracy Hoover | Audiologist | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236 | 2015-06-23 |
| 1780019539 | Song Jun Moon | Military Health Care Provider | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638 | 2013-09-12 |
| 1780943035 | Caroline Alice Bolduc | Internal Medicine | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236 | 2012-05-07 |
| 1962729939 | Jeffrey D Morgan | Emergency Medicine | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638 | 2010-04-29 |
| 1649594813 | Michael Hylton Edging | Nurse Practitioner | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638 | 2010-03-17 |
| 1386967982 | Charisma Bautista Evangelista | Ophthalmology | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236 | 2010-03-10 |
| 1619203429 | Amy Lynn | Nurse Practitioner | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-7517 | 2009-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346631876 | Christopher Jorgensen | General Practice | 2200 Bergquist Dr. Ste 1, Whasc/psychiatry - 59 Mhs/sgow, Lackland Afb, TX 78236-9908 | 2015-02-05 |
| 1114243128 | Eric Gerard Meyer II | General Practice | 2200 Bergquist Drive Ste 1, Whmc Psychiatry, Lackland Afb, TX 78236-9908 | 2010-04-15 |
| 1972031011 | George Benson | General Practice | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2017-06-02 |
| 1467984187 | Trevor Edgington | General Practice | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2017-03-31 |
| 1366855694 | William Dennis | General Practice | 1100 Wilford Hall Loop, Lackland Afb, TX 78236 | 2014-06-04 |
| 1922367242 | Alisa Anne Miller | General Practice | 2200 Bergquist Dr., Wilford Hall Amb Surgical Center, Lackland Afb, TX 78236-9908 | 2012-05-07 |
| 1427343920 | Alexis Anthon Beauvais | General Practice | 2200 Bergquist Drive, Wilford Hall Medical Center, Lackland Afb, TX 78263-9908 | 2011-06-13 |
| 1326226200 | Manuel A Nunez | General Practice | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2008-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577392 | Best Americare Visiting Doctors, Inc. | General Practice | 13601 Preston Rd Ste 706w, Dallas, TX 75240-5361 | 2020-10-30 |
| 1659978401 | Instaclinic, LLC | General Practice | 7008 Quartermile Ln, Dallas, TX 75248-1448 | 2020-10-05 |
| 1649887068 | Online Care Group Texas P.a. | General Practice | 6213 County Road 308, Rosharon, TX 77583-6321 | 2020-09-29 |
| 1689288342 | Nortex Medical Group | General Practice | 981 State Highway 121 Ste 4150, Allen, TX 75013 | 2020-09-01 |
| 1518577485 | Advanced Lifestyle Solutions Pllc | General Practice | 9560 Legacy Dr Ste 260, Frisco, TX 75033-6753 | 2020-08-05 |
| 1023627569 | Shepcole, Inc. | General Practice | 1431 Greenway Dr Ste 8000, Irving, TX 75038-2448 | 2020-07-30 |
| 1376151472 | Canice Chukwuocha | General Practice | 3030 Elmside Dr Apt 179, Houston, TX 77042-3926 | 2020-07-15 |
| 1902424518 | Medkare | General Practice | 2426 Lake Kolbe Ln, Houston, TX 77080-2562 | 2020-07-09 |
| 1528683810 | Umc El Paso Healthcare Inc | General Practice | 7500 Viscount Blvd Ste 140, El Paso, TX 79925-5692 | 2020-06-11 |
| 1770107542 | Texas Integrative Wellness Pllc | General Practice | 21660 Kingsland Blvd Ste 200, Katy, TX 77450-2511 | 2020-06-08 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on SAMUEL LEATHEN MADSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.