MEDICARE: DR. JOY R JOURDAN D.C.

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	111NN1001X	Nutrition Chiropractor	4741	TX

General Provider Information

NPI Number	:	1346519063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOY R JOURDAN D.C.

Provider Business Mailing Address
First Line	:	PO BOX 7005
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77248-7005
Country	:	US
Telephone Number	:	816-838-5808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 W 18TH ST
Second Line	:	#251
City	:	HOUSTON
State	:	TX
Zip	:	77008-1072
Country	:	US
Telephone Number	:	816-838-5808
Fax Number	:

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

Provider Enumeration Date	:	12/27/2011
Last Update Date	:	12/27/2011

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