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General NPI Number Information
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NPI Number | 1477477289
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Entity Type | Individual
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Provider Name | JORDAN BACA
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 7702 FM 1960 RD E STE 125
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City | HUMBLE
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State | TX
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Zip | 77346-2255
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Country | US
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Telephone | 713-396-0257
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Fax |
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Provider Business Mailing Address
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Address Line | 19270 JENNY LN
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City | PORTER
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State | TX
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Zip | 77365-6486
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Country | US
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Telephone | 281-910-6127
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 99320
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License Number State | TX
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