Provider Demographics
NPI:1356522759
Name:REDMAN, JOHN L (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:REDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SOUTH ROSS STERLING
Mailing Address - Street 2:PO BOX 398
Mailing Address - City:ANAHAUC
Mailing Address - State:TX
Mailing Address - Zip Code:77514
Mailing Address - Country:US
Mailing Address - Phone:409-267-4126
Mailing Address - Fax:409-267-4443
Practice Address - Street 1:621 S. ROSS STERLING
Practice Address - Street 2:
Practice Address - City:ANAHUAC
Practice Address - State:TX
Practice Address - Zip Code:77514
Practice Address - Country:US
Practice Address - Phone:409-267-3143
Practice Address - Fax:281-319-8520
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7563207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine