Individual
MR. KENNETH MICHAEL JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OWNER
Contact information
Practice address
4201 E LOOP 820 S, STE C, FT WORTH, TX 76119-4443
(817) 507-0185
(817) 507-2190
Mailing address
PO BOX 173248, ARLINGTON, TX 76003-3248
(817) 507-0185
(817) 507-2190
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
0304041589
TX
2471S1302X
Sonography Radiologic Technologist
Primary
—
TX
Other
Enumeration date
02/05/2007
Last updated
09/11/2025
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