Individual
JIZ ALPHONS MATHEW JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10860
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1136026
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
TX
Enumeration date
10/04/2016
Last updated
04/24/2025
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