Provider Demographics
NPI:1386657435
Name:KRAJCA-RADCLIFFE, JOAN B (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:B
Last Name:KRAJCA-RADCLIFFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BAMAKU BND
Mailing Address - Street 2:
Mailing Address - City:TIKI ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77554-7110
Mailing Address - Country:US
Mailing Address - Phone:713-444-8855
Mailing Address - Fax:
Practice Address - Street 1:111 BAMAKU BND
Practice Address - Street 2:
Practice Address - City:TIKI ISLAND
Practice Address - State:TX
Practice Address - Zip Code:77554-7110
Practice Address - Country:US
Practice Address - Phone:713-444-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN44352207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery