MEDICARE: MARGARET J. JORDAN PH.D.

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	103T00000X	Psychologist	31855	TX

General Provider Information

NPI Number	:	1437292166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET J. JORDAN PH.D.

Provider Business Mailing Address
First Line	:	3000 WESLAYAN ST
Second Line	:	SUITE 320
City	:	HOUSTON
State	:	TX
Zip	:	77027-5700
Country	:	US
Telephone Number	:	713-520-1121
Fax Number	:	713-522-1996

Provider Business Practice Location Address
First Line	:	3000 WESLAYAN ST
Second Line	:	SUITE 320
City	:	HOUSTON
State	:	TX
Zip	:	77027-5700
Country	:	US
Telephone Number	:	713-520-1121
Fax Number	:	713-522-1996

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/08/2007

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