Provider Demographics
NPI:1497987432
Name:AMADIO, JORDAN
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:AMADIO
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 1:1401 MEDICAL PKWY
Mailing Address - Street 2:BUILDING B SUITE 412
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5015
Mailing Address - Country:US
Mailing Address - Phone:512-409-9903
Mailing Address - Fax:
Practice Address - Street 1:1401 MEDICAL PKWY
Practice Address - Street 2:BUILDING B SUITE 412
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5015
Practice Address - Country:US
Practice Address - Phone:512-409-9903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-09
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5689207T00000X
CO0059473207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery