Dr. Edward Charles Shadiack III
Neuromusculoskeletal Medicine (NMM)
855 Montgomery St
Fort Worth
, Texas 76107-2553
Dr. Edward Charles Shadiack III
Neuromusculoskeletal Medicine (NMM)
855 Montgomery St
Fort Worth
, Texas 76107-2553
(817) 735-0633
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About
Features
Specialties
- Neuromusculoskeletal Medicine (NMM)
Languages spoken
- English
Location
First Address
- Dr. Edward Charles Shadiack III
- Po Box 99335
- Fort Worth, TX
- Zip : 76199-0335
- Phone : (817) 735-0633
Second Address
- Dr. Edward Charles Shadiack III
- 855 Montgomery St
- Fort Worth, TX
- Zip : 76107-2553
- Phone : (817) 735-2235
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | Q5562 | TX |
National Provider Identifier
| NPI | 1326278649 |
|---|---|
| Provider Name | Dr. Edward Charles Shadiack III |
| First Address | Fort Worth, TX 76199-0335 |
| Second Address | Fort Worth, TX 76107-2553 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/07/2009 |
| Last Update Date | 26/07/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.