Individual
PAUL JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E JONES ST, SHERMAN, TX 75090-7120
(903) 893-6222
Mailing address
PO BOX 332, DENISON, TX 75021-0332
(903) 893-6222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
ME3601
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
768683
COSMETOLOGY ESTABLISHMENT
TX
01
—
ME3601
MASSAGE THERAPY ESTABLISHMENT
TX
Enumeration date
08/30/2016
Last updated
08/30/2016
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