Individual provider · NPI-1

Madison O'Dwyer

Physical Medicine & Rehabilitation · Rockwall, TX

NPI number1336732064
StatusActive
Last updated in NPPESJul 16, 2024

Details

NPI
1336732064
Entity type
Individual (NPI-1)
Name
Madison O'Dwyer
Sex
Female
Sole proprietor
No
Enumeration date
Feb 13, 2021
Certification date
Jul 16, 2024
Last updated
Jul 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation1342479TXYes

Practice location

930 W Ralph Hall Pkwy Ste 120
Rockwall, TX 75032-6664

Phone 972-771-1090

Mailing address

930 W Ralph Hall Pkwy Ste 120
Rockwall, TX 75032-6664

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