Individual ProviderJordan James BaechleStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3601 4th Street Mail Stop 8143, Lubbock, TX 79430-0001(806) 743-6130PECOS EnrollmentBased on the most recent information from CMS, provider Jordan James Baechle does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1962250621Provider TypeIndividualFull NameBaechle, Jordan JamesCredentialMDGenderMaleSole ProprietorYesEnumeration Date5/8/2024Last Updated5/8/2024Contact InformationPractice LocationPractice Address3601 4th Street Mail Stop 8143, Lubbock, TX 79430-0001Phone(806) 743-6130Fax(806) 743-3955Mailing LocationMailing Address3601 4th Street Mail Stop 8143, Lubbock, TX 79430-0001Phone(806) 743-6130Fax(806) 743-3955Provider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer