Individual
DR. JEFFREY RYAN PADALECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 W 38TH ST, SUITE 102, AUSTIN, TX 78705-1000
(512) 282-8967
(512) 406-7330
Mailing address
6210 E HIGHWAY 290, AUSTIN, TX 78723-1142
(512) 483-9596
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
54060
TX
207X00000X
Orthopaedic Surgery Physician
Primary
N3968
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303081901
—
TX
05
—
303081902
—
TX
01
—
54060
TRAINING PERMIT
TX
Enumeration date
06/05/2007
Last updated
05/28/2021
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