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General NPI Number Information
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NPI Number | 1699905638
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Entity Type | Individual
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Provider Name | JUSTIN THOMAS JORDAN MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 2201 INWOOD ROAD
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City | DALLAS
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State | TX
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Zip | 75390-2621
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Country | US
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Telephone | 214-645-2499
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 INWOOD RD
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City | DALLAS
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State | TX
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Zip | 75235-7320
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Country | US
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Telephone | 214-645-2499
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | V7916
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License Number State | TX
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