Gary M Jordan, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

22431 Issued in TX

Practice address

7272 Wurzbach Rd
Suite 706
San Antonio, TX 78240-4801

Phone

(210) 615-3483

Fax

(210) 593-9863

NPI assigned

Nov 4, 2016

Last updated

Nov 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1790227957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 706",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3483",
            "fax_number": "210-593-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 706",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3483",
            "fax_number": "210-593-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "GARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "22431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "22431",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy Sharon Jordan Thomas, MD
• Ashanti Jordan
• Ashley Danielle Jordan
• Corinne Nicole Jordan, D.O.
• Devann Elaine Jordan
• Hilliard Earl Jordan Jr., MD
• Joann Jordan, RN
• John Gibbons Jordan Jr., M.D., M.P.H.
• Justina Jordan, MS, RDN, LDN
• Keisha Jordan

• Clinical Psychologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.