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NPI Code Detail

MEDICARE: DENISE JORDAN

MEDICARE: DENISE JORDAN
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
1106S00000XBehavior TechnicianRBT-26-510693TX

General Provider Information

NPI Number : 1407706724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE JORDAN
Provider Business Mailing Address
First Line : 6611 RIVER PLACE BLVD STE 105
Second Line :
City : AUSTIN
State : TX
Zip : 78730-1176
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6611 RIVER PLACE BLVD STE 105
Second Line :
City : AUSTIN
State : TX
Zip : 78730-1176
Country : US
Telephone Number : 512-308-3063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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Directions to “ DENISE JORDAN ” Practice Location

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