Provider Demographics
NPI:1619457769
Name:BORGER, JORDAN LEIGH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:LEIGH
Last Name:BORGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20610 RUSTON RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2053
Mailing Address - Country:US
Mailing Address - Phone:713-542-5677
Mailing Address - Fax:
Practice Address - Street 1:13428 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6275
Practice Address - Country:US
Practice Address - Phone:713-351-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist