Provider Demographics
NPI:1508583691
Name:VALLINA, KIRIA
Entity Type:Individual
Prefix:
First Name:KIRIA
Middle Name:
Last Name:VALLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 HORSE PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1715
Mailing Address - Country:US
Mailing Address - Phone:832-693-5851
Mailing Address - Fax:
Practice Address - Street 1:2150 HIGHWAY 6 S STE 180
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4328
Practice Address - Country:US
Practice Address - Phone:832-693-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily