Individual ProviderMadelaine WadeFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1500 S Main St, Fort Worth, TX 76104-4917(817) 702-1244(682) 207-4495PECOS EnrollmentBased on the most recent information from CMS, provider Madelaine Wade is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 10:04 AM.Profile DetailsProvider ID1306214341Provider TypeIndividualFull NameWade, MadelaineTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date9/8/2015Last Updated11/5/2024Contact InformationPractice LocationPractice Address1500 S Main St, Fort Worth, TX 76104-4917Phone(817) 702-1244FaxUnlisted FaxMailing LocationMailing Address1500 South Main Street, Jps Family Medicine Department, Fort Worth, TX 76104-3785Phone(682) 207-4495FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseV4774TexasCode133V00000XDescriptionDietitian, RegisteredDietary & Nutritional Service ProvidersLicense164.006645IllinoisCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerTexas