Jordyn Dean
Individual provider Active NPI Driver · Fulshear, TX
NPI 1912675752 · NPPES record last updated Sep 4, 2021
Key facts
- NPI
- 1912675752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 27222 Fulshear Bend Dr Apt 3308
Fulshear, TX 77441-1209 - Phone
- (310) 948-6776
- NPI assigned
- Sep 4, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boom Transportation Services LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
27222 Fulshear Bend Dr Apt 3308
Fulshear, TX 77441-1209
Mailing address
27222 Fulshear Bend Dr Apt 3308
Fulshear, TX 77441-1209
Phone (310) 948-6776
Other providers in Fulshear, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.