NPI 1467042879

Jordan Michael van de Vere, CPED

Practitioner Pedorthist Austin, TX

Practice location

Address: 4615 N Lamar Blvd STE 305, Austin, TX 78751-2357
Phone: (512) 476-5110
Fax: (512) 476-5178
Mailing address: 9901 N Capital of Texas Hwy STE 120, Austin, TX 78759-5853

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X

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Registry record

NPI: 1467042879
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jan 2021
Record last updated: 20 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.