Individual provider Active NPI

Craig Eugene Jordan, PH.D.

  • Assistive Technology Supplier Audiologist
  • Lackland a F B, TX
National Provider Identifier
1386638567
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistive Technology Supplier AudiologistTaxonomy code 231HA2500X
License
51026 Issued in TX
Practice address
2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907
Phone
(210) 536-2940
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 51026 TX
Assistive Technology Practitioner Audiologist 231HA2400X 51026 TX
Audiologist-Hearing Aid Fitter 237600000X 51026 TX
Assistive Technology Supplier Audiologist 231HA2500X 51026 TX Primary

Addresses

Primary practice location

2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907

Mailing address

13026 Hunters Breeze St
San Antonio, TX 78230-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
51026TXMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1386638567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13026 HUNTERS BREEZE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "SUITE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-536-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CRAIG",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51026",
            "primary": false
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "TX",
            "license": "51026",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "51026",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "TX",
            "license": "51026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland a F B, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.