Provider Demographics
NPI:1487967782
Name:JORDON, AMBER ROBIN (OD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:ROBIN
Last Name:JORDON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 S PADRE ISLAND DR
Mailing Address - Street 2:SUITE 119B MOORE PLAZA
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5425 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 119B MOORE PLAZA
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5301
Practice Address - Country:US
Practice Address - Phone:281-387-9811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7562TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist