Individual provider · Type 1 NPI
Jordan Michael Van de Vere, C. PED
Pedorthist · Austin, TX
NPI number
1467042879
Active
Practice location
4615 N Lamar Blvd Ste 305
Austin, TX 78751-2357
Fax (512) 476-5178
Mailing address
9901 N Capital Of Texas Hwy Ste 120
Austin, TX 78759-5853
Other practice locations
- 9901 N Capital Of Texas Hwy Ste 120, Austin, TX 78759-5853 · (512) 346-4400
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pedorthist Primary | 224L00000X | None listed |
Pedorthist: 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.
Other pedorthist providers in Austin
About NPI 1467042879
Jordan Michael Van de Vere, C. PED's National Provider Identifier is 1467042879, issued on Jan 20, 2021. The primary taxonomy on file is Pedorthist (224L00000X), and the practice location is in Austin, TX. The record was last updated on Jan 20, 2021.