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General NPI Number Information
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NPI Number | 1336886084
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Entity Type | Individual
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Provider Name | ALEXUS ELIZABETH JORDAN M.S., SLP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2022
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 8004 CAMERON RD
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City | AUSTIN
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State | TX
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Zip | 78754-3808
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Country | US
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Telephone | 512-501-3911
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 ED BLUESTEIN BLVD APT 10106
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City | AUSTIN
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State | TX
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Zip | 78723-0054
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Country | US
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Telephone | 318-512-5931
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 119416
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License Number State | TX
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