Provider Demographics
NPI:1508594011
Name:ETTERS, JORDAN (DACM)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:ETTERS
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 CAIRNWAY DR UNIT 842576
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77284-6115
Mailing Address - Country:US
Mailing Address - Phone:346-507-8727
Mailing Address - Fax:
Practice Address - Street 1:3100 RICHMOND AVE STE 390
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3053
Practice Address - Country:US
Practice Address - Phone:346-507-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01948171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist