| Jordan Family Healthcare | |
|
2636 S Loop W Suite 105 Houston TX 77054-2680 | |
| (832) 834-3800 | |
| (713) 748-4444 |
| Full Name | Jordan Family Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 2636 S Loop W, Houston, Texas |
| Authorized Official Name and Position | Rhonda Barnes Jordan (OWNER) |
| Authorized Official Contact | 8328343800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Family Healthcare 2636 S Loop W Suite 105 Houston TX 77054-2680 Ph: (832) 834-3800 | Jordan Family Healthcare 2636 S Loop W Suite 105 Houston TX 77054-2680 Ph: (832) 834-3800 |
| NPI Number | 1568653962 |
|---|---|
| Provider Enumeration Date | 08/09/2007 |
| Last Update Date | 05/13/2015 |
| Medicare PECOS PAC ID | 7618062746 |
|---|---|
| Medicare Enrollment ID | O20071003000666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568653962 | NPI | - | NPPES |
| 200014301 | Medicaid | TX | |
| 200014302 | Other | TX | TMHP STEPS TPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | L3571 (Texas) | Primary |
| Provider Name | Rhonda Barnes Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548213937 PECOS PAC ID: 1153219928 Enrollment ID: I20040304001358 |
| Provider Name | Shelby D Kiles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265793426 PECOS PAC ID: 8123326626 Enrollment ID: I20160418000756 |
| Provider Name | Patrice Nicola Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841669819 PECOS PAC ID: 9537468699 Enrollment ID: I20160425001857 |
| Provider Name | Trenise Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497356752 PECOS PAC ID: 9133516040 Enrollment ID: I20220425000324 |
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