Provider Demographics
NPI:1376035063
Name:JORDAN R. FEIN DPM, MS
Entity type:Organization
Organization Name:JORDAN R. FEIN DPM, MS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:832-301-9871
Mailing Address - Street 1:6243 FAIRMONT PKWY STE 203C
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4047
Mailing Address - Country:US
Mailing Address - Phone:832-301-9871
Mailing Address - Fax:281-630-2954
Practice Address - Street 1:6243 FAIRMONT PKWY STE 203C
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4047
Practice Address - Country:US
Practice Address - Phone:832-301-9871
Practice Address - Fax:281-630-2954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2324213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty