Provider Demographics
NPI:1093358392
Name:SALVADOR, JORDAN SARRA (APRN)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:SARRA
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 MCKINNEY AVE STE 155
Mailing Address - Street 2:#2354
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1488
Mailing Address - Country:US
Mailing Address - Phone:214-699-9146
Mailing Address - Fax:
Practice Address - Street 1:5148 VILLAGE CREEK DR STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5064
Practice Address - Country:US
Practice Address - Phone:469-661-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-20
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily