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Individual

DR. JEFFREY RYAN PADALECKI

Active
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Individual

DR. JEFFREY RYAN PADALECKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

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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