Provider Demographics
NPI:1174364186
Name:PEARSON, MADISON LEE (AUD)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LEE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5738 82ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2660
Mailing Address - Country:US
Mailing Address - Phone:806-687-4327
Mailing Address - Fax:806-687-8965
Practice Address - Street 1:5738 82ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2660
Practice Address - Country:US
Practice Address - Phone:806-687-4327
Practice Address - Fax:806-687-8965
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81628231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist