Provider Demographics
NPI:1629503214
Name:DOOLEY, JORDAN
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 W VAN BUREN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6400
Mailing Address - Country:US
Mailing Address - Phone:956-446-0136
Mailing Address - Fax:
Practice Address - Street 1:119 W VAN BUREN AVE STE 3
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6400
Practice Address - Country:US
Practice Address - Phone:956-446-0136
Practice Address - Fax:956-265-1284
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine