Provider Demographics
NPI:1134121775
Name:JORDAN, BELINDA V (MD)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:V
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5358
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5358
Mailing Address - Country:US
Mailing Address - Phone:956-362-5673
Mailing Address - Fax:956-362-2038
Practice Address - Street 1:5500 RAPHAEL DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-362-5673
Practice Address - Fax:956-362-2038
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1352207Q00000X, 207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151313705Medicaid
TX151313704Medicaid
TX151313705Medicaid
TX344985YZRCMedicare PIN
TXTXB164660Medicare PIN