Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP130500 | TX |
NPI | 1003262676 |
---|---|
Provider Name | Jordan L Hall |
First Address | Huffman, TX 77336-4656 |
Second Address | Houston, TX 77089-6041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2016 |
Last Update Date | 02/05/2019 |