Provider Demographics
NPI:1548848849
Name:TRUMAN, JORDAN ASHLEY (OTR)
Entity type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:ASHLEY
Last Name:TRUMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 GEORGI LN APT 191
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-5565
Mailing Address - Country:US
Mailing Address - Phone:832-248-8810
Mailing Address - Fax:
Practice Address - Street 1:1750 TOWNHURST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2811
Practice Address - Country:US
Practice Address - Phone:713-522-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121683225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist