Individual
BLAIR PHILIP JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
508 MEDICAL CENTER BLVD, STE 200, CONROE, TX 77304-2953
(936) 760-4600
(936) 760-4601
Mailing address
508 MEDICAL CENTER BLVD, STE 200, CONROE, TX 77304-2953
(936) 760-4600
(936) 760-4601
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F8180
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098632501
—
TX
Enumeration date
10/10/2006
Last updated
02/09/2022
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