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NPI Code Detail

MEDICARE: JORDAN R. FEIN DPM, MS

MEDICARE: JORDAN R. FEIN DPM, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist2324TX

General Provider Information

NPI Number : 1376035063
Entity Type Code : Organization
Provider Name (Legal Business Name) : JORDAN R. FEIN DPM, MS
Provider Business Mailing Address
First Line : 6243 FAIRMONT PKWY STE 203C
Second Line :
City : PASADENA
State : TX
Zip : 77505-4047
Country : US
Telephone Number : 832-301-9871
Fax Number : 281-630-2954
Provider Business Practice Location Address
First Line : 6243 FAIRMONT PKWY STE 203C
Second Line :
City : PASADENA
State : TX
Zip : 77505-4047
Country : US
Telephone Number : 832-301-9871
Fax Number : 281-630-2954
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : DR. JORDAN R FEIN
Credential : DPM
Telephone Number : 832-301-9871
Provider Enumeration Date : 05/30/2018
Last Update Date : 03/06/2020

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