Provider Demographics
NPI:1568946960
Name:YUEN, JORDAN (OTR/L)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:YUEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3571 FAR WEST BLVD # 3483
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3064
Mailing Address - Country:US
Mailing Address - Phone:575-640-8818
Mailing Address - Fax:
Practice Address - Street 1:3526 LONGMIRE DR STE 102
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6473
Practice Address - Country:US
Practice Address - Phone:575-640-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118464225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist