Provider Demographics
NPI:1023885977
Name:MCDANIEL, JARRAD ANGELO
Entity type:Individual
Prefix:
First Name:JARRAD
Middle Name:ANGELO
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 PLUMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-3645
Mailing Address - Country:US
Mailing Address - Phone:832-418-6679
Mailing Address - Fax:
Practice Address - Street 1:20008 CHAMPION FOREST DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8694
Practice Address - Country:US
Practice Address - Phone:832-418-6679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator