Healthcare Provider Details

I. General information

NPI: 1730994732
Provider Name (Legal Business Name): JORDAN NICOLE LLINAS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2025
Last Update Date: 02/08/2025
Certification Date: 02/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23144 CINCO RANCH BLVD STE E
KATY TX
77494-2893
US

IV. Provider business mailing address

8123 SUN TERRACE LN
HOUSTON TX
77095-4959
US

V. Phone/Fax

Practice location:
  • Phone: 281-769-2301
  • Fax:
Mailing address:
  • Phone: 832-260-8595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1403952
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: