Individual
DR. JORDAN LEE LAROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6835 AUSTIN CENTER BLVD, AUSTIN, TX 78731-3166
(512) 346-6611
Mailing address
6835 AUSTIN CENTER BLVD, AUSTIN, TX 78731-3166
(512) 346-6611
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DR.0067154
CO
207P00000X
Emergency Medicine Physician
Primary
N3816
TX
207P00000X
Emergency Medicine Physician
TRN9203
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029424
KAISER COMMERCIAL NUMBER
CO
05
—
287578301
—
TX
05
—
287578302
—
TX
05
—
9000203631
—
CO
Enumeration date
01/12/2007
Last updated
03/01/2023
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