Individual
DR. LA TONYA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2002 HOLCOMBE BLVD, MAILCODE 580/160, HOUSTON, TX 77030-4211
(713) 791-1414
Mailing address
2002 HOLCOMBE BLVD, MAILCODE 580/160, HOUSTON, TX 77030-4211
(713) 791-1414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2002001254
MO
122300000X
Dentist
Primary
22482
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175796502
—
TX
Enumeration date
03/05/2007
Last updated
03/25/2014
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