Provider Demographics
NPI:1336886084
Name:JORDAN, ALEXUS ELIZABETH (MS, SLP)
Entity Type:Individual
Prefix:
First Name:ALEXUS
Middle Name:ELIZABETH
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 ED BLUESTEIN BLVD APT 10106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-0054
Mailing Address - Country:US
Mailing Address - Phone:318-512-5931
Mailing Address - Fax:
Practice Address - Street 1:8004 CAMERON RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-3808
Practice Address - Country:US
Practice Address - Phone:512-501-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist