Jill A Radack
Pediatric Endocrinologist
1500 Cooper St
Fort Worth
, Texas 76104-2710
Jill A Radack
Pediatric Endocrinologist
1500 Cooper St
Fort Worth
, Texas 76104-2710
(682) 885-1396
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About
Features
Specialties
- Pediatric Endocrinologist
Languages spoken
- English
Location
First Address
- Jill A Radack
- Po Box 733784
- Dallas, TX
- Zip : 75373-3784
- Fax : (682) 885-1396
- Phone : (682) 885-1855
Second Address
- Jill A Radack
- 1500 Cooper St
- Fort Worth, TX
- Zip : 76104-2710
- Fax : (682) 885-1327
- Phone : (682) 885-7960
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0205X | Pediatric Endocrinologist | M0093 | TX |
National Provider Identifier
| NPI | 1306036686 |
|---|---|
| Provider Name | Jill A Radack |
| First Address | Dallas, TX 75373-3784 |
| Second Address | Fort Worth, TX 76104-2710 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/08/2007 |
| Last Update Date | 21/04/2021 |
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.