Provider Demographics
NPI:1790277861
Name:SCHRUTKA, JORDAN ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:ELIZABETH
Last Name:SCHRUTKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3840
Mailing Address - Country:US
Mailing Address - Phone:281-955-2650
Mailing Address - Fax:
Practice Address - Street 1:22485 TOMBALL PKWY STE 2100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1560
Practice Address - Country:US
Practice Address - Phone:281-955-2650
Practice Address - Fax:281-955-5875
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13020282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic