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General NPI Number Information
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NPI Number | 1992463707
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Entity Type | Individual
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Provider Name | DR. TAMMARA R JORDAN
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Gender | Female
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 2907 CLINTON DR
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City | HOUSTON
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State | TX
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Zip | 77020-8403
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Country | US
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Telephone | 346-256-2153
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 631342
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City | HOUSTON
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State | TX
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Zip | 77263-1342
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Country | US
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Telephone |
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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 | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | 111223
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | 11112223
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PGY088993
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License Number State | LA
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