Healthcare Provider Details

I. General information

NPI: 1497334635
Provider Name (Legal Business Name): JORDYN WALDRIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W CARTWRIGHT RD APT 1513
BALCH SPRINGS TX
75180-4847
US

IV. Provider business mailing address

PO BOX 494858
GARLAND TX
75049-4858
US

V. Phone/Fax

Practice location:
  • Phone: 214-200-1165
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: