JORDAN WOOD WILSON (NPI# 1508344037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508344037 |
| Entity Type | Individual |
| Full Name | JORDAN WOOD WILSON |
| Credential | PA-C |
| Practice Address |
1515 Holcombe Blvd Houston TX 77030 |
| Mailing Address |
Po Box 4439 Houston TX 77210-4439 |
| Practice Telephone | 7137926161 |
| Mailing Telephone | 7137922991 |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2019-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-12190 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8KK198 | 01 |
| TX | 393514001 | 05 | |
| TX | MEDICAID-CSHCN | 393514002 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16430 W Lake Houston Pkwy, Houston, TX 770446453 | 2814195544 | |
| 440 Rayford Rd Ste 125, Spring, TX 773864175 | 2814195544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962914341 | Jordan Wilson | Dietitian, Registered | 2075 E Flamingo Rd -southmagna, Room242, Las Vegas, NV 89119-5188 | 2017-10-25 |
| 1265951610 | Jordan Elisabeth Wilson | Behavior Technician | 1114 Main St Apt A, Danville, VA 24541-2954 | 2017-09-18 |
| 1568060879 | Jordan Leigh Wilson | Behavior Technician | 3012 E Hebron Pkwy Ste 118, Carrollton, TX 75010-4461 | 2020-10-09 |
| 1962041095 | Jordan Wilson | Case Manager/Care Coordinator | 3800 Watt Ave, Sacramento, CA 95821-2670 | 2020-01-07 |
| 1235775263 | Jordan Wilson | Pharmacist | 8745 S Emerson Ave, Indianapolis, IN 46237-9400 | 2019-11-25 |
| 1609346030 | Jordan Wilson | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2018-11-28 |
| 1578073821 | Jordan Wilson | Psychologist | 8140 Ashton Ave, Suite 200, Manassas, VA 20109 | 2017-10-01 |
| 1235651720 | Jordan Wilson | Physician Assistant | 2428 W Reynolds Ave, Centralia, WA 98531 | 2017-07-17 |
| 1710295951 | Jordan Nicole Wilson | Physical Therapy Assistant | 111 E Washington St, Bensenville, IL 60106-2674 | 2010-09-22 |
| Street Address |
1515 HOLCOMBE BLVD |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102126 | Najat Daw Bitar | Pediatrics | 1515 Holcombe Blvd, Houston, TX 77030-4009 | 2005-05-23 |
| 1447851852 | Jamie Dockery | Registered Nurse | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-11-03 |
| 1912507138 | Evelin Lidiet Umanzor | Nurse Practitioner | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-10-27 |
| 1285232447 | Federico A Oppliger Boettcher | Student in an Organized Health Care Education/Training Program | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-10-10 |
| 1043817026 | Lovette Noble Alegado | Nurse Practitioner | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-10-03 |
| 1578179297 | Reem Karami | Student in an Organized Health Care Education/Training Program | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-09-17 |
| 1093328973 | Shaun Brian Tindall II | Nurse Anesthetist, Certified Registered | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-08-28 |
| 1649882879 | Luana Guimaraes De Sousa | Student in an Organized Health Care Education/Training Program | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-08-19 |
| 1225648934 | Karizza J Cruz | Registered Nurse | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-08-06 |
| 1023628377 | Damaris Masila | Registered Nurse | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
| Find all providers in zip 77030 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345443 | Avery Rhodes Schwartz | Physician Assistant | 2206 Latexo Dr, Houston, TX 77018-1717 | 2020-10-28 |
| 1881291938 | Christine Nicole Nott | Physician Assistant | 13325 Hargrave Rd # 240, Houston, TX 77070-4539 | 2020-10-01 |
| 1306453659 | Christine Michelle Serewis - Pond | Physician Assistant | 950 Threadneedle St # 282, Houston, TX 77079-2925 | 2020-09-29 |
| 1902412828 | Chen-ho Yang | Physician Assistant | 1818 Memorial Dr Ste 200, Houston, TX 77007-8383 | 2020-09-16 |
| 1437769833 | Aviva Tziporah Rogozen | Physician Assistant | 4550 N Braeswood Blvd Apt 331, Houston, TX 77096-2883 | 2020-07-31 |
| 1417575671 | Harmeet Kaur | Physician Assistant | 9601 Jones Rd Ste 238, Houston, TX 77065-4774 | 2020-07-13 |
| 1780201939 | Evelyn Oliva | Physician Assistant | 4943 Brenner St, Houston, TX 77022-2536 | 2020-07-02 |
| 1093330722 | Stephanie Kochuparambil | Physician Assistant | 2630 Bissonnet St Apt 5213, Houston, TX 77005-1571 | 2020-06-09 |
| 1376171587 | Samad Syed Ali | Physician Assistant | 12702 Morning Glory Meadow Ln, Houston, TX 77089-1551 | 2020-04-01 |
| 1235765660 | Samantha Salcedo | Physician Assistant | 6651 Main St Ste 1420, Houston, TX 77030-2351 | 2020-03-17 |
| Find all providers in HOUSTON | ||||
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| 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.