Individual
MADELINE FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
806 WATER ST, BASTROP, TX 78602-3832
(512) 409-3116
Mailing address
206 MOSSBERG LN, BASTROP, TX 78602-4077
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
24583
TX
Other
Enumeration date
03/03/2026
Last updated
03/03/2026
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