Individual
MR. JORDAN MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1807 W SLAUGHTER LN, AUSTIN, TX 78748-6230
(512) 282-8967
Mailing address
4506 WILD DUNES CT, AUSTIN, TX 78747-1302
(210) 912-7763
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
547877
TX
2471C3402X
Radiography Radiologic Technologist
Primary
547877
TX
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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