Provider Demographics
NPI:1861480402
Name:JORDAN, MARIA LUISA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LUISA
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27920 TOMBALL PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6476
Mailing Address - Country:US
Mailing Address - Phone:281-290-7777
Mailing Address - Fax:281-378-6808
Practice Address - Street 1:27920 TOMBALL PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6476
Practice Address - Country:US
Practice Address - Phone:281-290-7777
Practice Address - Fax:281-378-6808
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G48610Medicare UPIN
8F7361Medicare PIN