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Individual

MS. JENNIFER JEAN JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
5145 FM 620 N STE B-110, AUSTIN, TX 78732-1815
(512) 266-0007
(512) 266-0077
Mailing address
5145 FM 620 N STE B-110, AUSTIN, TX 78732-1815
(512) 266-0007
(512) 266-0077

Taxonomy

Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
PA04718
TX
363AM0700X
Medical Physician Assistant
Primary
PA04718
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00393129
RAILROAD MEDICARE
Enumeration date
08/31/2006
Last updated
05/11/2020
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