Provider Demographics
NPI:1053130096
Name:SHIFLET, MADISON (BT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:SHIFLET
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 KELLER PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3877
Mailing Address - Country:US
Mailing Address - Phone:682-291-9910
Mailing Address - Fax:
Practice Address - Street 1:7500 SAN FELIPE ST. SUITE 990
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063
Practice Address - Country:US
Practice Address - Phone:866-610-0580
Practice Address - Fax:866-611-1558
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician