Provider Demographics
NPI:1033764188
Name:REDMON, KIARA M (PA)
Entity Type:Individual
Prefix:MISS
First Name:KIARA
Middle Name:M
Last Name:REDMON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 FANNIN ST STE 610.31
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2609
Mailing Address - Country:US
Mailing Address - Phone:832-822-1508
Mailing Address - Fax:
Practice Address - Street 1:6701 FANNIN ST STE 610.31
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2609
Practice Address - Country:US
Practice Address - Phone:832-822-1508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical