JORDAN MICHAEL VAN DE VERE C. PED NPI 1467042879

NPI Information

Jordan Michael Van De Vere, C. PED is a pedorthist in Austin, TX. The provider is an individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. Jordan Michael Van De Vere, C. PED NPI is 1467042879. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4615 N LAMAR BLVD STE 305
AUSTIN, TX
ZIP 78751-357
Phone: (512) 476-5110
Fax: (512) 476-5178

The enumeration date for this NPI number is 1/20/2021 and was last updated on 1/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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