MEDICARE: MS. JENNIFER JEAN JORDAN P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	PA04718	TX
2	363AM0700X	Medical Physician Assistant	PA04718	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00393129	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1164534699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER JEAN JORDAN P.A.

Provider Business Mailing Address
First Line	:	5145 FM 620 N STE B-110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1815
Country	:	US
Telephone Number	:	512-266-0007
Fax Number	:	512-266-0077

Provider Business Practice Location Address
First Line	:	5145 FM 620 N STE B-110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1815
Country	:	US
Telephone Number	:	512-266-0007
Fax Number	:	512-266-0077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/11/2020

Similar Medicare Providers

1730151549 — DR. MELODY RENE VANDER STRATEN MD
Practice Location Address:

5145 N FM 620 RANCH ROAD, BLDG I
AUSTIN, TX
78732-1815

Practice Phone: 512-681-5900
Practice Fax: 512-681-5922

1578520102 — ANA URUKALO DPM
Practice Location Address:

5145 N FM 620 BLDG I
AUSTIN, TX
78732-1815

Practice Phone: 512-681-5900
Practice Fax: 512-681-5922

1124079306 — DR. EDWARD LEWIS LAIN M.D.
Practice Location Address:

5145 FM 620 N STE B-110
AUSTIN, TX
78732-1815

Practice Phone: 512-266-0007
Practice Fax: 512-266-0077

1821004953 — MRS. SUSAN GAINEY FERGUSON R.PH.
Practice Location Address:

5145 FM 620 N
AUSTIN, TX
78732-1815

Practice Phone: 512-266-1392
Practice Fax:

1477827673 — RANDALLS FOOD & DRUGS LP
Practice Location Address:

5145 N FM 620 , SUITE A
AUSTIN, TX
78732-1815

Practice Phone: 512-266-1392
Practice Fax: 512-266-4796

1235533647 — JAMES RUSSELL ALLGOOD
Practice Location Address:

5145 FM 620 N STE F-130
AUSTIN, TX
78732-1815

Practice Phone: 512-554-9937
Practice Fax:

Directions to “ MS. JENNIFER JEAN JORDAN P.A.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.