IndividualActive
Jordan Van De Vere, C. PED
NPI 1467042879 · Pedorthist · Austin, TX
Provider details
- NPI number
- 1467042879
- Entity type
- Individual
- Primary specialty
- PedorthistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- C. PED
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4615 N Lamar Blvd Ste 305
Austin, TX 78751-2357
Phone: (512) 476-5110
Fax: (512) 476-5178
Approximate (ZIP-level) locationGet directions
Mailing address
9901 N Capital of Texas Hwy Ste 120
Austin, TX 78759-5853
Additional practice locations (1)
- 9901 N Capital of Texas Hwy Ste 120Austin, TX 78759-5853Phone: (512) 346-4400Fax: (512) 346-3009
Registry dates
- Enumerated
- 2021-01-20
- Last updated
- 2021-01-20
- Certified
- 2021-01-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.