Basic Information
| Provider Information | |||||||||
| NPI: | 1003235193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPARKMAN | ||||||||
| FirstName: | JORDAN | ||||||||
| MiddleName: | DANIEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1504 TAUB LOOP, 5TH FLOOR GASTROENTEROLOGY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138733503 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1504 TAUB LOOP, 5TH FLOOR GASTROENTEROLOGY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138732000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2014 | ||||||||
| LastUpdateDate: | 07/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | BP10049483 | TX | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RG0100X | R3221 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.