Individual
DR. CHARLES MATTHEW JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 SCOTT AND WHITE BLVD, COLLEGE STATION, TX 77840-5601
(979) 691-3442
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
P0740
TX
390200000X
Student in an Organized Health Care Education/Training Program
76358
TX
Other
Enumeration date
06/27/2008
Last updated
09/17/2013
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