Healthcare Provider Details

I. General information

NPI: 1851895346
Provider Name (Legal Business Name): JORDAN HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6551 MAIN ST RM E.1940.14
HOUSTON TX
77030
US

IV. Provider business mailing address

6551 MAIN ST RM E.1940.14
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-5800
  • Fax:
Mailing address:
  • Phone: 832-824-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberW0925
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: