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General NPI Number Information
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NPI Number | 1932719416
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Entity Type | Individual
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Provider Name | ERYN CASEY JORDAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/09/2020
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Last Update Date | 08/09/2020
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Provider Practice Location Address
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Address Line | 621 HIGHLANDER AVE
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-3525
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Country | US
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Telephone | 214-432-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 8940 VERMILLION ST APT 9309
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-1626
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Country | US
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Telephone | 214-934-6416
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5360
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 121064
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License Number State | TX
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