Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0100X | Occupational Health | 11112223 | TX |
Y | 111NX0100X | Occupational Health | 111223 | LA |
NPI | 1992463707 |
---|---|
Provider Name | Dr. Tammara R Jordan |
First Address | Houston, TX 77263-1342 |
Second Address | Houston, TX 77020-8403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |