Provider Demographics
NPI:1568644805
Name:BELINDA V JORDAN, MD, PA
Entity Type:Organization
Organization Name:BELINDA V JORDAN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-3763
Mailing Address - Street 1:2621 W TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3432
Mailing Address - Country:US
Mailing Address - Phone:956-631-3763
Mailing Address - Fax:956-632-0933
Practice Address - Street 1:2621 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3432
Practice Address - Country:US
Practice Address - Phone:956-631-3763
Practice Address - Fax:956-632-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1352207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0044KQOtherBLUE CROSS BLUE SHIELD
TX00972VMedicare PIN
TX0044KQOtherBLUE CROSS BLUE SHIELD