Individual
MR. JOEL R JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17270 RED OAK DR, SUITE 200, HOUSTON, TX 77090-2632
(281) 440-6960
(281) 440-6205
Mailing address
PO BOX 4356, DEPT. 665, HOUSTON, TX 77210-4356
(281) 440-6960
(281) 440-6205
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
TX
363AS0400X
Surgical Physician Assistant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101051754
DPS
TX
01
—
PA05169
TEXAS LICENSE
TX
Enumeration date
02/27/2007
Last updated
03/07/2023
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