Provider Demographics
NPI:1801117908
Name:JORDAN, MAEGAN LANETTE (PHARMD)
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:LANETTE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 QUIET ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7589
Mailing Address - Country:US
Mailing Address - Phone:832-788-9701
Mailing Address - Fax:
Practice Address - Street 1:2805 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2191
Practice Address - Country:US
Practice Address - Phone:713-578-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-13
Last Update Date:2010-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist