Individual ProviderMadison LackeyStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice AddressTtuhsc Department Of Neurology 3601 Street - Stop 8321, Lubbock, TX 79430-0001(989) 860-3697PECOS EnrollmentBased on the most recent information from CMS, provider Madison Lackey does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1841033917Provider TypeIndividualFull NameLackey, MadisonCredentialMDGenderMaleSole ProprietorYesEnumeration Date6/17/2024Last Updated6/17/2024Contact InformationPractice LocationPractice AddressTtuhsc Department Of Neurology 3601 Street - Stop 8321, Lubbock, TX 79430-0001Phone(989) 860-3697FaxUnlisted FaxMailing LocationMailing AddressTtuhsc Department Of Neurology 3601 Street - Stop 8321, Lubbock, TX 79430-0001Phone(989) 860-3697FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseBP10090140Texas