Jill A Radack, MD
Pediatrics, Pediatric Endocrinology in Fort Worth, TX. Individual provider (NPI-1).
NPI number1306036686
StatusActive
Last updated in NPPESSep 12, 2024
Details
- NPI
- 1306036686
- Entity type
- Individual (NPI-1)
- Name
- Jill A Radack
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 1, 2007
- Certification date
- Sep 12, 2024
- Last updated
- Sep 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0205X | Pediatrics, Pediatric Endocrinology | M0093 | TX | Yes |
Practice location
1500 Cooper StFort Worth, TX 76104-2710
Phone 682-885-7960 · Fax 682-885-1327
Mailing address
Po Box 733784Dallas, TX 75373-3784
Phone 682-885-1855 · Fax 682-885-1396
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