Radiant Medspa, PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

RADIANT MEDSPA, PLLC

Practice address

2701 Cross Timbers Rd Ste 224
Flower Mound, TX 75028-2779

Phone

(214) 222-5823

NPI assigned

Jul 3, 2024

Last updated

Jul 3, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kevin Douglas Fradkin, MDNPI 1972603934

Title

Managing Member

Phone

(214) 222-5823

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin D Fradkin, M.D.

  • Surgery Physician
  • Houston, TX
  • NPI 1972603934
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1639915291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 E SOUTHLAKE BLVD STE L-229",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CROSS TIMBERS RD STE 224",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282779",
            "telephone_number": "214-222-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT MEDSPA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "FRADKIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-222-5823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quan Zhao DMD PLLC
• Dorella Leigh Quinn, LPC
• Adriana L Quintero, LMFTA
• Keith Edwin Rachow
• Catherine Regina Radford
• Lisa Ragsdale, RN
• Megan Rahn, MRC, LPC
• Aamir Mushtaq Rai, MD
• Rakesh Gupta MD PA
• Sabine Rakos, LCSW

• Surgery Physician in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.