Provider Demographics
NPI:1487103396
Name:JORDAN, JIZ ALPHONS MATHEW (PA-C)
Entity type:Individual
Prefix:
First Name:JIZ ALPHONS
Middle Name:MATHEW
Last Name:JORDAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16651 SOUTHWEST FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2393
Mailing Address - Country:US
Mailing Address - Phone:281-494-4900
Mailing Address - Fax:
Practice Address - Street 1:16651 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2393
Practice Address - Country:US
Practice Address - Phone:281-494-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10860363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1136026OtherNATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS