Provider Demographics
NPI:1407487697
Name:HARRIS, KIYDRA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIYDRA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CLEBURNE STREET
Mailing Address - Street 2:SAMUEL NABRIT SCIENCE BUILDING, OFFICE 135-D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-4598
Mailing Address - Country:US
Mailing Address - Phone:713-313-7248
Mailing Address - Fax:
Practice Address - Street 1:5656 KELLEY ST
Practice Address - Street 2:OC MEDICINE CLINIC-CPII OFFICE
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026
Practice Address - Country:US
Practice Address - Phone:334-524-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX574441835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care