Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jack Michael Raisanen, MD

Individual provider Neuropathology Physician · NPI 1083673115

Dr. Jack Michael Raisanen, MD is a Pathology in Dallas, Texas. Graduated from University of Michigan Medical School in 1986, 40 years ago. Practices with University of Texas Southwestern Medical Center at Dallas, a 3,149-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
40
Trained at
University of Michigan Medical School
Licensed in
TX
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone: (214) 648-1620
Fax: (214) 648-4080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neuropathology Physician (primary) Taxonomy 207ZN0500X · Licence L1177 (TX)

Record details

NPI number1083673115
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 18, 2006
Last updated in NPPESDecember 1, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolUNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated 1986 (40 years in practice)
Group practice University Of Texas Southwestern Medical Center At Dallas — 3149 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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