MANDY J JORDAN


Address: 855 Montgomery St, Fort Worth, TX 76107-2553
Phone: 8177352400

MANDY J JORDAN (NPI# 1306160080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306160080
Entity Type Individual
Full Name MANDY J JORDAN
Credential PHD
Practice Address 855 Montgomery St
Fort Worth
TX 76107-2553
Mailing Address Po Box 99335
Fort Worth
TX 76199-0335
Practice Telephone 8177352400
Practice Fax Number 8177350615
Mailing Telephone 8177352400
Mailing Fax Number 8177350615
Enumeration Date 2010-03-24
Last Update Date 2016-05-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
34438 TX Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX BCBS 88008A 01
TX 212411701 05

Other Providers MANDY JORDAN

NPI Name Taxonomy Address Enumeration
1417254913 Mandy Ann Jordan Counselor 1004 Carbon, Trinidad, CO 81082-3664 2011-02-17
1104012871 Mandy Jordan Marriage & Family Therapist 21545 Centre Pointe Pkwy, Santa Clarita, CA 91350-2947 2007-09-17

Office Location

Street Address 855 MONTGOMERY ST
City FORT WORTH
State TX
Zip Code 76107-2553

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831194455 Patricia Lowrimore Psychiatry & Neurology 855 Montgomery St, Fort Worth, TX 76107-2553 2005-06-20
1194353417 Jason L Thompson Student in an Organized Health Care Education/Training Program 855 Montgomery St, Fort Worth, TX 76107-2553 2020-03-31
1639701808 Tyrane Roberts-lagrone Pharmacist 855 Montgomery St, Fort Worth, TX 76107-2553 2020-02-06
1144860917 Melissa Edwards Petersen Clinical Neuropsychologist 855 Montgomery St, Fort Worth, TX 76107-2553 2020-01-09
1629553813 Lisa Jane Killam-worrall Pharmacist 855 Montgomery St, Fort Worth, TX 76107-2553 2018-10-03
1598250607 Sima Taj Mozdbar Optometrist 855 Montgomery St, Fort Worth, TX 76107-2553 2018-06-30
1588153993 Kristen Reuter Social Worker 855 Montgomery St, Fort Worth, TX 76107-2553 2018-05-02
1114431624 Emily J. Clark Counselor 855 Montgomery St, Fort Worth, TX 76107-2553 2017-11-20
1275073215 Elizabeth Svyatoslavna Balyakina Student in an Organized Health Care Education/Training Program 855 Montgomery St, Fort Worth, TX 76107-2553 2017-02-23
1588103659 Frederick Olen Barnum Iv Family Medicine 855 Montgomery St, Fort Worth, TX 76107-2553 2017-02-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629683602 Renovo Wound and Hyperbarics Pllc Emergency Medicine 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 2020-09-15
1669085437 Ryan Bourgeois Nurse Practitioner 2917 Crocket Street, Fort Worth, TX 76107 2020-08-31
1053920546 Christa Marie Widjaja Optometrist 1700 Montgomery St, Fort Worth, TX 76107 2020-07-30
1093351355 Raymond Iannone Pharmacist 850 Montgomery St, Suite #310, Fort Worth, TX 76107 2019-11-21
1053963744 Cumulus Injury Resolution, Inc. Chiropractor 4936 Byers Avenue, Fort Worth, TX 76107 2019-07-12
1770135576 Shadia Osakwe Physician Assistant 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 2019-07-11
1568945442 Sachin P Patel Physical Therapist 4825 Wellesley St, Fort Worth, TX 76107 2018-09-07
1023594025 Ftw Pharmacy Services Inc Durable Medical Equipment & Medical Supplies 2912 W 6th St Ste 150, Fort Worth, TX 76107 2018-07-13
1669974325 Helen Williamson Elliott Counselor 1751 River Run #217, Fort Worth, TX 76107 2018-03-08
1487156931 Pelvic Neuromonitoring Pllc Electrodiagnostic Medicine 111 Boland St #211, Ft Worth, TX 76107 2018-03-01
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265931349 Ramona Diane Burroughs Psychologist 855 Montgomery St Fl 4, Fort Worth, TX 76107-2553 2018-02-05
1689115438 Hayley Blackwood Psychologist 15833 Bent Rose Way, Fort Worth, TX 76177 2017-03-13
1326582941 David K. Carlson Psychologist 5112 Leeray Rd, Fort Worth, TX 76244-9233 2016-12-16
1639625171 Mary Madison Eagle Psychologist 4837 Bryce Ave, Fort Worth, TX 76107-4144 2016-08-25
1831546944 Kalima Charway Psychologist 4532 Endercrest Lane, Fort Worth, TX 76123 2016-05-18
1821332628 Patricia Byrd Psychologist 3000 'j' Street, Fort Worth, TX 76127 2012-11-16
1629224068 Daniel Rayner Altman Psychologist 1200 W Magnolia Ave, Suite 210, Fort Worth, TX 76104-4481 2008-08-18
1407027279 Mary Cecilia Robertson Psychologist 6420 Southwest Blvd, Suite 112, Fort Worth, TX 76109 2008-03-19
1043429426 Nichelle E. Wiggins Psychologist 3804 E Lancaster Ave, Fort Worth, TX 76103-3523 2007-05-22
1871718007 George C. Denkowski Psychologist 1701 River Run Ste 1105, Fort Worth, TX 76107-6557 2007-04-14
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Competitor

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City FORT WORTH
Zip Code 76107

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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