Individual
GERRY L MADDOUX
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3710 21ST ST, LUBBOCK, TX 79410-1220
(806) 780-8003
Mailing address
3710 21ST ST, LUBBOCK, TX 79410-1220
(806) 780-8003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J0992
TX
Other
Enumeration date
06/09/2005
Last updated
07/08/2007
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