Healthcare Provider Details

I. General information

NPI: 1548581309
Provider Name (Legal Business Name): LAURA J RADEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA A JAMES M.D.

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-0078
  • Fax: 469-626-8512
Mailing address:
  • Phone: 469-626-8512
  • Fax: 214-645-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125067498
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberT7009
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: