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General NPI Number Information
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NPI Number | 1346454410
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Entity Type | Organization
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Legal Business Name | JORDAN ASHA, PLLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 11595 S WILCREST DR
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City | HOUSTON
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State | TX
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Zip | 77099-4752
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Country | US
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Telephone | 832-328-3077
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Fax | 832-328-3081
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Provider Business Mailing Address
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Address Line | 11595 S WILCREST DR
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City | HOUSTON
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State | TX
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Zip | 77099-4752
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Country | US
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Telephone | 832-328-3077
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Fax | 832-328-3081
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. ROBERT ORTIZ
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Credential |
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Telephone | 832-328-3077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G7248
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | G7248
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | G7248
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G7248
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License Number State | TX
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