MEDICARE: DR. RHONDA BARNES JORDAN M.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	207Q00000X	Family Medicine Physician	L3571	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548213937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHONDA BARNES JORDAN M.D

Provider Business Mailing Address
First Line	:	10021 MAIN ST STE B3
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-5254
Country	:	US
Telephone Number	:	832-834-3800
Fax Number	:	713-748-4444

Provider Business Practice Location Address
First Line	:	10021 MAIN ST STE B3
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-5254
Country	:	US
Telephone Number	:	832-834-3800
Fax Number	:	713-748-4444

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	09/19/2019

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