Provider Demographics
NPI:1588489371
Name:BOYKIN, JORDAN TOMIA
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:TOMIA
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 SAN FELIPE ST STE 990
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12725 RACE TRACK RD
Practice Address - Street 2:
Practice Address - City:WESTCHASE
Practice Address - State:FL
Practice Address - Zip Code:33626-1314
Practice Address - Country:US
Practice Address - Phone:813-467-7190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician