Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. EDWARD CHARLES SHADIACK III, D.O.
Active Sole ProprietorDR. EDWARD CHARLES SHADIACK III, D.O. is a Electrodiagnostic Medicine healthcare provider located in FORT WORTH, Texas. NPI 1326278649 is currently active in the NPPES registry. Verify at CMS.
Electrodiagnostic Medicine · FORT WORTH, TX
Registration Details
- NPI Number
- 1326278649
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 21, 2009 (17.084144593274 yrs)
- Last Updated
- Jul 21, 2022
- License
-
Q5562 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
855 MONTGOMERY STFORT WORTH, TX, 761072553Browse TX providers · Browse ZIP 76107
- Phone
- 8177352235
- Primary Specialty
-
Electrodiagnostic Medicine
204D00000X
Other Electrodiagnostic Medicine Providers in FORT WORTH, TX
| Name | Credential | NPI |
|---|---|---|
| RICHARD TODD DOMBROSKI | DO | 1144209552 |
| KENDI HENSEL | DO | 1023080769 |
| JERRY DICKEY | DO | 1245203488 |
| DR. JOHN LICCIARDONE | D.O. | 1407829641 |
| RUSSELL GAMBER | DO | 1700859154 |
| DR. DAVID EDWARD TEITELBAUM | D.O. | 1366498438 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.