Provider Demographics
NPI:1568653962
Name:RHONDA BARNES JORDAN, MD PA
Entity Type:Organization
Organization Name:RHONDA BARNES JORDAN, MD PA
Other - Org Name:JORDAN FAMILY HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:BARNES
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-834-3800
Mailing Address - Street 1:2636 S LOOP W
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2680
Mailing Address - Country:US
Mailing Address - Phone:832-834-3800
Mailing Address - Fax:713-748-4444
Practice Address - Street 1:2636 S LOOP W
Practice Address - Street 2:SUITE 105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2680
Practice Address - Country:US
Practice Address - Phone:832-834-3800
Practice Address - Fax:713-748-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3571261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200014301Medicaid
TX200014302OtherTMHP STEPS TPI
TX200014302OtherTMHP STEPS TPI