MEDICARE: JORDYN KRISTINE SONS-GRAHAM PA-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	363A00000X	Physician Assistant	PA18308	TX

General Provider Information

NPI Number	:	1770305351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDYN KRISTINE SONS-GRAHAM PA-C

Provider Business Mailing Address
First Line	:	9850 EMMETT F LOWRY EXPY
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2000
Country	:	US
Telephone Number	:	409-938-2234
Fax Number	:

Provider Business Practice Location Address
First Line	:	9850 EMMETT F LOWRY EXPY
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2000
Country	:	US
Telephone Number	:	409-938-2234
Fax Number	:

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

Provider Enumeration Date	:	10/25/2024
Last Update Date	:	10/25/2024

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Directions to “ JORDYN KRISTINE SONS-GRAHAM PA-C” Practice Location

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