Individual
EMILY JORDAN MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
36065 SANTA FE AVE, FORT CAVAZOS, TX 76544-5060
(254) 288-8000
Mailing address
2102286243, JBSA FT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2395
NE
208D00000X
General Practice Physician
2395
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/19/2019
Last updated
08/08/2023
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