Individual
JACOB I JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
501 MIDWESTERN PKWY E, WICHITA FALLS, TX 76302-2302
(940) 766-8807
(833) 563-0799
Mailing address
501 MIDWESTERN PKWY E, WICHITA FALLS, TX 76302-2302
(940) 766-8807
(888) 563-0799
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
758186
TX
Other
Enumeration date
01/09/2013
Last updated
07/02/2024
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